2021, Vol. 4, Issue 3, Part A
Comparison between rocuronium and cisatracurium: Efficacy and safety, in patients requiring general anesthesia: A randomized prospective study
Author(s): Dr. Usha Badole, Dr. S Udhaya Sankar, Dr. Anisha Venugopal Suvarna and Dr. Shruti Yelsangikar
Abstract: Background: Neuromuscular blockers (NMB) are very important adjuvant to general anesthesia, Rocuronium bromide (aminosteroidal NMB) and cisatracurium besylate (benzyl isoquinoline NMB) are intermediate acting non-depolarizing muscle relaxants. In a prospective randomized study we had compared both drug at a dose of 3xED95 for Rocuronium and 6xED95 for Cisatracurium as regard the onset of action, intubating conditions, clinical duration, hemodynamic changes, and adverse effects.
Method: 60 patients, ASA I&II, 20-60 year old underwent elective surgerical procedure under general anesthesia (GA) were randomly assigned into 2 equal groups. ROC group, where 1mg/kg rocuronium was given and CIS group, where 0.3mg/kg cisatracurium was given. Neuromuscular monitoring was done by stimulating ulnar nerve and recording the action potential of adductor pollicis using TOF count. Standardized GA was given to all patients as follows, fentanyl 2mcg/kg, propofol 2mg/kg,followed by NMB agent of corresponding group at designated dose, patient will be ventilated till TOF count reaches 0, intubation was tried by the anaesthesiologist who was blind to the given NMB, intubation was done if the intubating condition was acceptable (excellent or good), and it was re-attempted every 30 sec if it was poor or inadequate. Anesthesia was maintained by N2O, O2 and sevoflurane to a total MAC 1, controlled ventilation was adjusted to normocarbia. Mean arterial blood pressure (MAP), heart rate, and intubating conditions were recorded. Interpretation of TOF count for the onset of action, clinical duration, recovery index was done.
Results: Clinically acceptable intubating conditions were achieved after 60 sec more frequently after rocuronium (80%) than after cisatracurium(0%)and after 90 sec rocuronium (98%)and Cisatracurium(60%). Rocuronium had a significant shorter onset time than cisatracurium (90±30 versus 120±30sec), Rocuronium had a significant shorter duration of action than cisatracurium (35±5 versus 45±5min). There were no evidences of any significant clinical cardiovascular changes in both groups. There were no clinical signs of histamine release in both groups.
Conclusion: Rocuronium has a rapid onset of action with good intubating conditions, cisatracurium has an intermediate duration of action, both are potent and safe with excellent cardiovascular stability and without apparent histamine release.
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How to cite this article:
Dr. Usha Badole, Dr. S Udhaya Sankar, Dr. Anisha Venugopal Suvarna, Dr. Shruti Yelsangikar. Comparison between rocuronium and cisatracurium: Efficacy and safety, in patients requiring general anesthesia: A randomized prospective study. Int J Med Anesthesiology 2021;4(3):23-29. DOI: 10.33545/26643766.2021.v4.i3a.276