Atracurium besilate 25mg/2.5ml solution for injection ampoules

Atracurium and cisatracurium are commonly used non-depolarizing neuromuscular blocking agents during general anesthesia. Their comparative effects on onset of complete neuromuscular blockade and early hemodynamic stability remain clinically relevant in elective abdominal surgery. Objective: To compare cisatracurium and atracurium in terms of hemodynamic status and time to achieve complete neuromuscular blockade among patients undergoing elective abdominal surgeries. Methods: This randomized controlled trial was conducted in the Department of Anesthesia, Nishtar University Hospital, Multan, Pakistan, from December 2023 to December 2024. A total of 278 ASA-I patients aged 18–50 years undergoing elective abdominal surgery under general anesthesia were included. Patients were divided into two equal groups: Group A received atracurium 0.5 mg/kg, while Group B received cisatracurium 0.2 mg/kg. Neuromuscular blockade was assessed using train-of-four monitoring. Heart rate and mean arterial pressure were recorded at baseline and at one-minute intervals for 10 minutes after drug administration. Data were analyzed using SPSS version 23, and p<0.05 was considered statistically significant. Results: The mean age of patients was 35.42 ± 7.03 years, and 151 (54.3%) were male. Baseline demographic and operative characteristics were comparable between the groups. Cisatracurium produced significantly faster complete neuromuscular blockade than atracurium, with a mean time to TOF score 0 of 169.12 ± 16.17 seconds versus 186.16 ± 13.77 seconds, respectively (p<0.001). A higher proportion of patients in the cisatracurium group achieved TOF score 0 within 180 seconds compared with the atracurium group (76.3% vs 33.1%, p<0.001). Atracurium was associated with a mild early rise in heart rate and greater early reduction in mean arterial pressure, while cisatracurium showed better early hemodynamic stability. Conclusion: Cisatracurium was superior to atracurium in achieving earlier complete neuromuscular blockade with more stable early hemodynamic response.</jats:p

Abstract licence: CC BY-NC