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Cisatracurium is a new non-depolarizing, benzylisoquinolinium neuromuscular blocking drug with intermediate duration of action .It is a stereoisomer of atracurium with a potency of approximately 3 to 4 times greater than that of atracurium. Despite the higher potency, cisatracurium is associated with more stable hemodynamics than atracurium and does not cause histamine release even at doses of upto 0.4mg/kg (8×ED95). The recommended intubating dose is 0.15mg/kg (3×ED95) & High Most of the previous clinical studies have compared equipotent doses of atracurium and cisatracurium and concluded that atracurium is more effective than cisatracurium at same dose (2×ED95). However, few studies have shown that increasing the dose of cisatracurium to 4×ED95 (0.2mg/kg) and 6×ED95 (0.3mg/kg) provided more effective neuromuscular blockade and excellent cardiovascular stability with no marked histamine release clinically. Hence the present study was done in order to test the intubating conditions and hemodynamic stability of cisatracurium at 2 ×ED95 and 4×ED95 doses.Methods: Randomised controlled trial conducted, after ethical committee clearance and informed written consent from patient. Sixty patients of ASA 1 and 2 aged 20 -60 yrs of both sexes coming for elective surgeries under general anaesthesia. Patients were divided into two groups, so each, group A received 0.1mg/kg (2*ED95) and group B received 0.2mg/kg(4*ED95) loading dose of cisatracurium.Results: Intubating conditions were satisfactory with group B compared to group A and was statistically significant. Better hemodynamic stability with respect to mean pulse rate, systolic blood pressure and mean arterial pressure in group B compared to group A and was statistically significant. Conclusion: 4*ED95 doses of cisatracurium provides better intubating conditions and more stable hemodynamic status than 2*ED95. There was no untoward effects noted clinically.

A clinical comparative study of different doses of cisatracurium for intubation in patients undergoing general anaesthesia