Comparison Of Clinical Effects Between Intermittent Infusion And Continuous Infusion Cisatracurium

Objective: In the recent years,cisatracurium has been widely used in clinical anesthesia.because of cisatracurium has many merits, such as strong effect,no accumulation, no histamine released, little affect on cardic blood vessel and metabolite was of avirulention, no muscle relaxation, etc.All these make it become the best ideal muscle relaxant.Traditionally, it will be administered by intermittent injection, but it is difficult to keep plasma concentration stable to maintain constant neuromuscular blockade , even because of untimely or a large cumulative dose, we have to face the problem of residual block or prolonged recovery.With the invention of micro pump, more and more people use it to administer.In this observation , we try to compare the clinical effects of cisatracurium administered by intermittent injection and continuous infusion,expect to get a more reasonable way in the clinical use of neuromuscular blockade.Methods: 20 patients scheduled for elective epigastrium surgery divided into two equal groups were randomly allocated to intermittent infusion(A group) or continuous infusion(B group).ASA physical statusⅠorⅡ, free of cardiac,pulmonary,renal or neuromuscular disease.Their ages were between 18～50 years, their weights were limit to 20% fluctuation of their normal weights. All patients received premedication with IM Atropine (0.5mg) and Luminal(0.1g)30 minutes before anesthesia.We chose TIVA and monitored HR,BP and SPO2 continuously, and at the same time we monitored neuromuscular block(NMB), and the NMB was assessed by electromy- ography and the desired degree of NMB was 15% (T1/TC=10%). Anesthesia was induced with Midazolam 3mg,Fentanyl 0.2mg,etomidate 20mg, cisatracurium 0.2mg/kg(4ED95),In group A ,when T1/TC=5%～10%, cisatracurium was used for muscle relaxation by intermittent infusion 0.1mg/kg. In group B , when T1/TC=5%, cisatracurium was administered at the concentration of 3μg/㎏·min, after 20～30min , at the concentration of 1～2μg/㎏·min, to maintain T1/TC=10%, we stopped infusing cisatra- curium when the surgeons to end after 20 minutes.Monitor indexes:memorized the followings:when we stopped infusing drugs , the recovery index and TOF70%.the consumption of propofol, midazolam, fentanyl and cisatracurium.The results were expressed with"X±S", statistic analysis was performed with T test to examine intergroup differences.Results: There was not significant statistical difference of the recovery index and the consumption of propofol, midazolam, fentanyl, cisa- tracurium. but there was significant statistical difference of the recovery velocity.Those explained that cisatracucium had no accumulation effects. under the NMB, in group B can keep plasma concentration stable to main- tain constant neuromuscular blockade and shorten the recovery velocity.the superiority of the continuous injection over the intermittent bolus injection, it also decreased the work load of the clinical anesthesia.