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[The effect of different priming doses on the pharmacodynamics of cisatracurium]
F K Pühringer1, A Scheller, A Kleinsasser
1Universitätsklinik für Anaesthesie und Allgemeine Intensivmedizin, Leopold Franzens Universität Innsbruck, Osterreich. friedrich.puehringer@uibk.ac.at
Objective:
The aim of the study was to evaluate the effect of two different priming regimen on the onset time of 100 micrograms/kg cisatracurium, when compared to bolus administration.
Methods:
51 patients were randomly assigned and received either a bolus of 100 micrograms/kg cisatracurium, or a priming dose of 10 micrograms/kg cisatracurium followed after 4 min by 90 micrograms/kg cisatracurium, or a priming dose of 15 micrograms/kg cisatracurium followed after 4 min by 85 micrograms/kg cisatracurium. The neuromuscular monitoring was performed using a mechanomyograph (Groningen II Monitor). Anaesthesia was induced with propofol and fentanyl and maintained by continuous infusion of propofol.
Results:
The priming combination of 15 micrograms/kg cisatracurium followed after 4 min by 85 micrograms/kg cisatracurium produced a statistically significant reduction in the onset time (95% block) (180 +/- 60 s) and time to complete block (210 +/- 48 s), when compared to the bolus group (240 +/- 60 s and 288 +/- 66 s) (p < 0.05).
Conclusion:
Our data indicate that the "priming principle" is an appropriate technique to shorten the onset time of cisatracurium. To achieve a maximum effect the priming combination of 15 micrograms/kg cisatracurium followed after 4 min by 85 micrograms/kg cisatracurium is recommended.
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