title: No regional difference in cisatracurium dose-response and time-course-of-action between patients in China and Bosnia.
abstract: BACKGROUND
  Variability in drug response could result from a variety of genetic and environmental factors that are often hard to define or quantify. A number of studies demonstrated regional geographic variations in potency of neuromuscular blocking agents (NMBAs). The aim of our study was to compare dose-response and time-course-of-action of cisatracurium besylate, an NMBA eliminated via the Hoffman degradation, in two countries with different life habits, diet, and ambient conditions; being Han Chinese in China and Caucasians in Bosnia.
  
  
  METHODS
  Neuromuscular block of cisatracurium 20 µg kg(-1), followed by four incremental 10 µg kg(-1) doses, and the remainder of 100 µg kg(-1) was evaluated using the Relaxometer mechanomyograph (Groningen University, Groningen, The Netherlands). Dose-response curves were created using log-dose-probit-response transformation.
  
  
  RESULTS
  There were no significant differences in cisatracurium mean (95% confidence intervals) ED(50), ED(90), and ED(95) (effective doses for 50%, 90%, and 95% first twitch depression) in Caucasian [39.1 (35.7-42.3), 50.6 (45.5-54.3), and 54.4 (49.8-58.9) µg kg(-1)] compared with Chinese patients [39.2 (35.1-43.1), 52.4 (47.9-56.8), and 56.9 (52.8-61.9) µg kg(-1)], respectively. There were no significant differences in mean (sd) Dur(25) and Dur(0.9) (time until 25% first twitch and 0.9 train-of-four ratio recoveries) in Caucasian [47.1 (6.4) and 77.5 (9.1) min)] compared with Chinese patients [(45.9 (4.7) and 72.3 (9.1) min)], respectively.
  
  
  CONCLUSIONS
  Cisatracurium dose-response relationship and time-course-of-action were not influenced by geographic location. Thus, cisatracurium would not require dose adjustments between patients living in the two geographic locations.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria. ashraf.dahaba@medunigraz.at
authors.forename: A A
authors.initials: AA
authors.lastname: Dahaba
authors.forename: I
authors.initials: I
authors.lastname: Suljevic
authors.forename: H
authors.initials: H
authors.lastname: Bornemann
authors.forename: X-M
authors.initials: XM
authors.lastname: Wu
authors.forename: H
authors.initials: H
authors.lastname: Metzler
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D001279:Atracurium / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D017522:Bosnia and Herzegovina / Q000208:ethnology; D002681:China / Q000208:ethnology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008875:Middle Aged; D009469:Neuromuscular Junction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage* / Q000494:pharmacology; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; C101584:cisatracurium