Infusion and bolus administration of cisatracurium--effects on histamine release

The purpose of this study is to evaluate the usefulness of Cisatracurium Besilat (CB), and the method of its administration during laparotomies on adult patients, to determine whether CB caused cutaneous, systemic or chemical evidence of histamine release. This study was conducted as a randomized, double-blind clinical trial on 38 patients (ASA I-II). After a standard anesthetic induction with fentanyl and propofol, patients received an i.v. bolus CB (0.15 mg/kg in Group A (n=20) or Group B (n=18). In Group B, 0.18 mg/kg/h infusion was started. Following reaching stable muscle relaxations for intraabdominal operation and for recovery, Group A (Bolus group) and Group B (Infusion group) were compared. Train-of-four fade during recovery of block were recorded after administration of CB. The heart rate and arterial blood pressure were monitored noninvasively. There were no significant hemodynamic differences among the groups. 25%-75% spontaneous recoveries were (mean+/-s) 12.75+/-4.52, 16.11+/-9.20 minutes for Group A, Group B. 70% TOF Ratios were (mean+/-s) 1.07+/-0.13, 1.39+/-0.38 hours for the same groups. There was no consistent correlation between hemodynamic changes, cutaneous manifestations and histamine concentrations. We conclude that CB does not cause systemic or cutaneous histamine release. The infusion method of cisatracurium has a stable level of curarization without side effect and there were no significant recovery time differences between the groups.