title: Effects of Combined Rocuronium and Cisatracurium in Laparoscopic Cholecystectomy.
abstract: BACKGROUND
  Laparoscopic upper abdominal surgery can cause spontaneous respiration due to diaphragmatic stimulation and intra-abdominal CO2inflation. Therefore, sufficient muscle relaxation is necessary for a safe surgical environment.
  
  
  METHODS
  We investigated if the combination of rocuronium and cisatracurium can counteract the delayed onset of cisatracurium's action and delayed recovery of muscle relaxation and whether the dosage of rocuronium, which is metabolized hepatically, can be reduced. A total of 75 patients scheduled for laparoscopic cholecystectomy with an American Society of Anesthesiology physical status I-II, in the age range of 20-60 years, and with a 20-30 kg/m2body mass index were included in the study.
  
  
  RESULTS
  The patients were divided into the following groups: combination group (Group RC, rocuronium 0.3 mg/kg and cisatracurium 0.05 mg/kg), rocuronium group (Group R, rocuronium 0.6 mg/kg), and cisatracurium group (Group C, cisatracurium 0.1 mg/kg), and the onset, 25% duration, recovery index, and addition/time ratio were measured. Patients in Group RC exhibited a significantly different addition/time ratio compared with patients in the other two groups (p = 0.003).
  
  
  CONCLUSIONS
  During laparoscopic cholecystectomy, the 95% effective dose of rocuronium in combination with cisatracurium is expected to provide a sufficient muscle relaxant effect.
authors.affiliation: Department of Anesthesia, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates; Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Woo Young
authors.initials: WY
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kwang Ho
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Young Bok
authors.initials: YB
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Myeong Hoon
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Hyun Kyo
authors.initials: HK
authors.lastname: Lim
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University, Suwon, Korea.
authors.forename: Jong Bum
authors.initials: JB
authors.lastname: Choi
keywords: Cholecystectomy; Cisatracurium; Laparoscopy; Rocuronium