ISSN:
1432-1238
Keywords:
Key words Neuromuscular blocking agents
;
Atracurium
;
Cisatracurium
;
Recovery
;
Neuromuscular blockade
;
Intensive care
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Objective: To investigate the infusion requirements and recovery characteristics of cisatracurium compared with atracurium when both are administered by prolonged continuous infusion. Design: A prospective, randomised, single-blind study. Settings: The Intensive Care Unit of the Manchester Royal Infirmary. Patients: 20 patients requiring a continuous infusion of a neuromuscular blocking agent to facilitate mechanical ventilation. 12 patients received cisatracurium and 8 received atracurium. Interventions: Cisatracurium or atracurium was administered by continuous infusion for a minimum of 24 h. The level of neuromuscular blockade was measured by recording the train-of-four responses using acceleromyography, the aim being to maintain 1–2 twitch responses of the adductor pollicis. At the end of the infusion period, the train-of-four was recorded until the ratio was greater than 0.7. Measurements and results: The mean infusion rate of cisatracurium was 0.23 mg kg−1 h−1, compared to 0.62 mg kg−1 h−1. No time-related increase in infusion requirements was seen for either drug. The mean recovery time to a train-of-four ratio greater than 0.7 was the same (46 min). There was no correlation between recovery time and age, duration of infusion or mean infusion rate. Conclusions: Cisatracurium provides a satisfactory level of neuromuscular blockade in adult ICU patients at approximately one-third the infusion rate of atracurium and with a similar recovery time.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01709749
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