title: Cisatracurium vs. Rocuronium: A prospective, comparative, randomized study in adult patients under total intravenous anaesthesia.
abstract: OBJECTIVE
  To compare the pharmacodynamics of cisatracurium and rocuronium-induced neuromuscular block following single dose, allowing either spontaneous or neostigmine-accelerated complete recovery.
  
  
  METHODS
  Following the ethics committee approval and informed consent, 120 patients scheduled for elective surgery under TIVA with tracheal intubation were randomized into 4 groups with different cisatracurium (CIS, 0.10 or 0.15 mg.kg(-1)) or rocuronium (ROC, 0.60 or 0.90 mg.kg(-1)) doses administered. For each patient, the onset time for 95 % depression of T1, clinical duration until 25 % recovery, recovery index (T1 from 25 to 75 %) and time from T1 25 % to TOF-ratio 0.9 were determined allowing either spontaneous or induced recovery.
  
  
  RESULTS
  The onset times were 277 (SD 58), 220 (46), 91 (16) and 77 (16) s for the CIS 0.10, CIS 0.15, ROC 0.60 and ROC 0.90 groups (p < 0.05), respectively, with lower variability in both ROC groups (p < 0.05). The clinical durations were 42 (7), 52 (7), 35 (11) and 52 (12) min, respectively (p < 0.05 for lower doses). Recovery index was identical in all groups allowing either spontaneous recovery - 15.9 (1.8), 15.5 (1.7), 16.1 (3.7) and 16.1 (4.0) min, or following neostigmine administration - 4.4 (0.9), 4.5 (0.8), 4.3 (0.8) and 4.7 (0.7) min for respective groups. During spontaneous recovery, the variability of DUR25-TOF90 was twice as great for ROC than CIS groups (p < 0.05), while after neostigmine administration it was uniform in all groups.
  
  
  CONCLUSIONS
  For equipotent doses, the onset times for CIS were approximately three times longer than for ROC. The average clinical duration for both relaxants ranged from 35 to 52 min with acceptable variability. Neostigmine administration accelerated the recovery and reduced its variability. When allowing for spontaneous recovery, less scatter was demonstrated for both CIS groups than for ROC ones.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital and Faculty of Medicine, Palacky University, Olomouc, Czech Republic. milan.adamus@seznam.cz
authors.forename: Milan
authors.initials: M
authors.lastname: Adamus
authors.forename: Radim
authors.initials: R
authors.lastname: Belohlavek
authors.forename: Jirina
authors.initials: J
authors.lastname: Koutna
authors.forename: Mariana
authors.initials: M
authors.lastname: Vujcikova
authors.forename: Eva
authors.initials: E
authors.lastname: Janaskova
mesh_terms: D000732:Androstanols / Q000008:administration & dosage*; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous; D001279:Atracurium / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D000077123:Rocuronium
chemical_list: D000732:Androstanols; D009466:Neuromuscular Blocking Agents; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; C101584:cisatracurium; D000077123:Rocuronium