Muscle Relaxation Of Cisatracurium In Patients Of Head And Neck Neoplasms

Partâ… Muscle relaxation of 0.15mg/kg cisatracurium in patients of benign or malignant head and neck neoplasmsObjective: To investigate the muscle relaxation of 0.15 mg/ kg cisatracurium in patients of benign or malignant head and neck neoplasms.Methods: Thirty ASAâ…¡-â…¢patients, aged 18-64 yr, body mass index<30 kg/m², undergoing elective operation of head and neck neoplasms, were allocated into 2 groups according to the results of the preoperative pathology: benign tumor group (group B, n=15) and malignant tumor group (group M, n=15). All the patients were unpremeditated. Electrocardiogram (ECG) and heart rate (HR), noninvasivel mean arterial blood pressure (MAP), systolic blood pressure (SBP), diastolic arterial blood pressure (DBP), peripheral oxygen saturation (SpO₂), bispectral index (BIS), PETCO₂ and muscle relaxation which used the single stimulus (0.1 HZ, 0.2 ms, 60 mA, interaction 10 s) of the adductor pollicis muscle following supramaximal eletrica stimutation of the ulnar nerve were continuously monitored. Anesthesia was induced with remifentanil and propofol both given by TCI simultaneously (pharmocokinetic parameters reported by Minto and Marsh were used respectively). The target concentrations of propofol were set at 3μg/ml and remifentanil at 6 ng/ml. When the patients lost consciousness, cisatracurium 0.15 mg/kg was given intravenously to facilitate the tracheal intubation in group B and M respectively. When T1 dropped to 25%, the tracheal intubate was performed. The patients were mechanically ventilated and P_ETCO₂ was maintained between 30-40 mm Hg. Anesthesia was maintained with TCI of propofol (3-6μg/kg) combined with remifentanil (3-6 ng/kg) to maintain BIS index between 45-55. MAP and HR were record before anaesthesia and at 1 and 5 min after anaesthesia. The onset time (S₁), the clinical effect time (S₂), and the time of T1 recovering to 25% and 75% (S_3,4)and the recovery index (S₅) of cisatracurium were also record. The condition of tracheal intubation was evaluated.Results: There were no significant differences between the 2 groups before induction of anesthesia (P>0.05). The clinical effect time, the time of T₁ recovering to 25% and 75% and the recovery index of cisatracurium (S_2-5) were significantly prolonged in group M compared with group B. There were no significant differences between the 2 groups in onset time.Conclusion: The clinical effect time, recovery time and recovery index of cisatracurium in patients of malignant tumor were longer than that in patients of benign tumor.Partâ…¡Muscle relaxation of different dose cisatracurium in patients of malignant head and neck neoplasms Objective: To investigate the muscle relaxation of different dose cisatracurium in patients of malignant head and neck neoplasms.Methods: Thirty five ASAâ…¡-â…¢patients of malignant, aged 18-64 yr, body mass index<30 kg/m², undergoing elective operation of head and neck neoplasms. According to the dose of cisatracurium, the patients were further randomly allocated into three groups(n=15 each): cisatracurium 0.1 mg/kg group (2ED₉₅, group M₂), cisatracurium 0.15 mg/kg group (3ED₉₅, group M₃), cisatracurium 0.20 mg/kg group (4ED₉₅, group M4). The induction and maintenance of anesthesia, monitoring and monitoring index were similar with Partâ… .Results: There were no significant differences among the 3 groups before induction of anesthesia (P>0.05). The onset time of cisatracurium (S₁) was significantly prolonged, and the clinical effect time and the time of T₁ recovering to 25% and 75% of cisatracurium (S_2-4) were significantly shortened in group M₂ compared with group M₃ (P<0.05). The onset time of cisatracurium was significantly shortened, and the clinical effect time and the time of T-1 recovering to 25% and 75% of cisatracurium (S_2-4) were significantly prolonged in group M4 compared with group M₃ (P<0.05). There was no significant differences in the recovery index of cisatracurium (S₅) between group M₂, M₃ and M₄ (P>0.05).Conclusion: With the increase of cisatracurium, the onset time was shortened, and the clinical effect time and the time of recovering were prolonged,but the recovery index of cisatracurium was not affected by the dose in patients of malignant tumor.