Novosti
Khirurgii
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Научно-практическая конференция с международным участием и
XXVIII Пленум Правления Белорусской ассоциации хирургов
«Актуальные вопросы и современные подходы в оказании
хирургической помощи в Республике Беларусь»
18-19 ноября 2021 года в г. Минск.






Year 2015 Vol. 23 No 1

ANESTHESIOLOGY & REANIMATOLOGY

DOI: http://dx.doi.org/10.18484/2305-0047.2015.1.91   |  

A.L. LIPNITSKI, A.V. MAROCHKOV

COMPARATIVE EVALUATION OF CISATRACURIUM AND ATRACURIUM ACTION AS COMPONENTS OF ENDOTRACHEAL ANESTHESIA IN LAPAROSCOPIC SURGERIES

ME "Mogilev Regional Hospital",
The Republic of Belarus

Objectives. To carry out the comparative evaluation of cisatracurium and atracurium as a component of a balanced endotracheal anesthesia for the abdominal laparoscopic surgeries.
Methods. 80 patients at the age of 18-70, who had undergone the laparoscopic cholecystectomy, were enrolled in the prospective randomized study. All patients received cisatracurium 0,1 mg / kg (the 1st group) or atracurium 0,3 mg / kg (the 2nd group). Monitoring of neuromuscular transmission is carried out according to Stockholm criteria of the pharmacodynamic studies of myorelaxants action.
Results. Cisatracurium administration (270 (225-330) had faster onset time of neuromuscular block in comparison with the 2nd – 390 (210-540) (p<0,01). In the 1st group intubation conditions were excellent in 28 (66,7%) cases, in the 2nd group – in 13 (34,2%) patients (p<0,05), and poor – in 3 cases (1st group), in 12 cases, (p<0,05) in the 2nd group. Duration of action of atracurium was reliably lower – 31,5 (25-37) min in comparison with cisatracurium – 43 (40-50) min (p<0,05). In atracurium group total number of complications / side effects was higher than in cisatracurium group, in 2nd group – 16 and 5 – in the 1st group (p<0,05). Serious complications related to regional anesthesia have not been observed.
Conclusion. Low doses of cisatracurium (0,1 mg/kg) cause faster onset and create better conditions for tracheal intubation, compared with that of atracurium. Cisatracurium (0,1 mg/kg) proved tо have a longer duration of action than atracurium (0,3 mg/kg).

Keywords: myorelaxants, cisatracurium, atracurium, neuromuscular block, general anesthesia, randomized controlled trial
p. 91-96 of the original issue
References
  1. Kanus II, Grachev SS. Klinicheskaia kharakteristika myshechnykh relaksantov nedepoliarizuiushchego tipa deistviia [Clinical characteristics of non-depolarizing muscle relaxants type of action]. Med Panorama.. 2005;(5):3-6
  2. Bryson HM, Faulds D. A review of its pharmacology and clinical potential in anaesthetic practice. Cisatracurium Besilate.1997 May;53(5):848-66.
  3. Kleinman W, Nitti GJ, Nitti JT, Raya J. Neuromuscular blocking agents. In: Morgan GE, Mikhail MS, Murray MJ, editors. Clinical anesthesiology. 4th Ed. New York: Lange Medical Books/McGraw Hill Medical publishing Division; 2006. p. 205.
  4. Mellinghoff H, Radbruch L, Diefenbach C, Buzello W.A comparison of cisatracurium and atracurium: onset of neuromuscular block after bolus injection and recovery after subsequent infusion. Anesth Analg. 1996 Nov;83(5):1072-75.
  5. Kanus II, Grachev SS. Sravnitel'naia kharakteristika pokazatelei deistviia arduana, arkurona i esmerona pri abdominal'nykh operativnykh vmeshatel'stvakh [Comparative characteristics of action arduana, arkurona and esmerone in abdominal surgery]. Novosti Khirurgii. 2010:18(6):82-89.
  6. Marochkov AV, Lipnitskii AL. Primenenie magniia sul'fata s tsel'iu potentsirovaniia nizkikh doz rokuroniia [The use of magnesium sulfate for the purpose of potentiating of low doses of rocuronium]. Novosti Khirurgii. 2012;20(6):98-104.
  7. Lipnitskii AL, Marochkov AV. Primenenie magniia sul'fata s tsel'iu potentsirovaniia malykh doz atrakuriia i rokuroniia [The use of magnesium sulfate for the purpose of potentiating of low doses of atracurium and rocuronium]. Vestn Anesteziologii i Reanimatologii. 2014;11(3):30-40.
  8. Fuchs-Buder C, Claudius LT, Skovgaard LI, Eriksson RK, Mirakhur and J Viby-Mcgexsex. Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: the Stockholm revision T. Acta Anaesthesiol Scand 2007; 51:789-808.
  9. El-Kasaby AM, Atef HM, Helmy AM, El-Nasr MA.Cisatracurium in different doses versus atracurium during general anesthesia for abdominal surgery. Saudi J Anaesth. 2010 Sep;4(3):152-57.
  10. Moore EW, Hunter JM.The new neuromuscular blocking agents: do they offer any advantages? Br J Anaesth. 2001 Dec;87(6):912-25.
  11. Movafegh A, Amini S, Sharifnia H, Torkamandi H, Hayatshahi A, Javadi M.Cost analysis and safety comparison of Cisatracurium and Atracurium in patients undergoing general anesthesia. Eur Rev Med Pharmacol Sci. 2013 Feb;17(4):447-50.
  12. Kirov K, Motamed C, Decailliot F, Behforouz N, Duvaldestin P.Comparison of the neuromuscular blocking effect of cisatracurium and atracurium on the larynx and the adductor pollicis. Acta Anaesthesiol Scand. 2004 May;48(5):577-81.
  13. Adamus M, Hrabalek L, Wanek T, Gabrhelik T, Zapletalova J. Influence of age and gender on the pharmacodynamic parameters of rocuronium during total intravenous anesthesia. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2011 Dec;155(4):347-53.
  14. Sparr HJ. Choice of the muscle relaxant for rapid-sequence induction. Eur J Anaesthesiol Suppl. 2001;23:71-76.
Address for correspondence:
212002, Respublika Belarus,
g. Mogilev, ul. B. Biruli d. 12,
ME "Mogilev Regional Hospital",
otdelenie anesteziologii i reanimatsii,
tel. office: +375 222 278 733,
e-mail: lipnitski.al@gmail.com,
Lipnitski Artur Leonidovich
Information about the authors:
Lipnitski A.L. A head of the transplant-coordination department of ME "Mogilev Regional Hospital".
Marochkov A.V. MD, professor, a head of the anesthesia and intensive care department of ME "Mogilev Regional Hospital".
Contacts | ©Vitebsk State Medical University, 2007