A Comparative Study of Atracurium and Cisatracurium in paediatric cleft Lip and Cleft palate surgeries

• Published in: Research journal of pharmacy and technology 2020-02, Vol.13 (2), p.867-870
• Main Authors: Shrey, Shruti, Singam, Amol
• Format: Article
• Language: English
• Subjects: Anesthesia; Blood pressure; Drug dosages; Heart rate; Histamine; Intubation; Pediatrics; Surgery
• ISSN: 0974-3618; 0974-360X; 0974-306X
• DOI: 10.5958/0974-360X.2020.00164.X

Alongwith intubating conditions, onset and duration of action, hemodynamic effects, and signs of histamine release were measured in both the groups.In the atracurium group the mean score according to 'Cooper et al'scale was 6.86±0.54,whereas in the cisatracurium group it was 8.12±0.64, the difference between the groups was statistically significant.Time of onset was found to be 2.7±0.12 minutes in the cisatracurium group and 3.28±0.64 minutes in the atracurium group.Duration of action was 64.6±6.18minutes in the cisatracurium group as compared to 35.4±4.64minutes in the atracurium group.Cisatracurium(0.2mg/kg) is more efficacious as compared to atracurium(0.5mg/kg)with respect to intubating conditions, it has a faster onset of action, good intraoperative hemodynamic parameters, longer duration of action with no side effects. According to the literature published earlier comparison of the intubating conditions according to the 'Cooper et al scale'[7] between 2 ED95 of atracurium and cisatracurium showed that atracurium provided better intubating conditions than cisatracurium. Anaesthesia was maintained with a mixture of 50% N2O in O2 and sevoflurane with assisted ventilation.After attaining a stable base line of vital hemodynamic parameters, the muscle relaxant was given to patients according to the previously mentioned initial doses for each group and injected intravenously within 5-10 s. Neuromuscular monitoring was carried out after obtaining the control values by supramaximal stimulus (70mA) from relaxograph (2 Hz/0.5s; pulse width 0.2 ms) every 15s to stimulate the ulnar nerve via surface electrodes. Intra-operative hemodynamic changes were continuously monitored including: heart rate (HR), mean arterial blood pressure (MABP) every 15 min, oxygen saturation (SO2), and end tidal CO2.Body temperature maintained between 35 and 37°C by means of warmed IV fluids and warming blankets.