Pharmacodynamic Interactions Between Cisatracurium And Rocuronium

ObjectiveTo demonstrate the effect of administrating a precurarizing dose of cisatracurium and rocuronium at a priming time of 3 minutes on decreasing the onset time of cisatracurium for tracheal intubation, and determine the duration and recovery profile of maintenance doses of cisatracurium following rocuronium.MethodA total of 60 patients with ASAâ… -â…¡scheduled for elective surgery were randomized into 1 of 4 groups. Group I received intubation dose of cisatracurium 0.15mg/kg. Group II received rocuronium 0.09mg/kg while group III received cisatracurium 0.015mg/kg as a priming dose, and after a 3-minute priming time, intubation doses of cisatracurium 0.135mg/kg were given.Group IV received intubation dose of rocuronium 0.9mg/kg.Anesthesia for 4 groups were maintained with cisatracurium 0.03mg/kg. Neuromuscular blockade was monitored using acceleromyography. The time for the first twitch height percentage (T1/T0%) reached zero (the onset of cisatracurium) and the evoked EMG to spontaneously return to 25%,75% and calculate the recovery index.ResultGroupâ…¡and Groupâ…¢can significantly accelerate the onset of cisatracurium (P<0.05), but still longer than Groupâ…£. Besides females in Groupâ…£had a faster onset of paralysis than did males(P<0.05), and old patients in Groupâ…£had a longer duration of paralysis than did young ones(P<0.05). The clinical duration of the first and last maintenance doses (cisatracurium) was prolonged when administered after rocuronium (Group IV) (P<0.05). Howerer, there were no statistical differences in the recovery index (P>0.05)ConclutionPriming with rocuronium and cisatracurium can significantly accelerate the onset of cisatracurium,and the clinical duration and maintenance doses of cisatracurium was prolonged following rocuronium.