European Journal of Cardiovascular Medicine

Introduction: Atracurium is a benzyl-isoquinolinium, non-depolarizing neuromuscular blocking agent of intermediate duration of action. It has revolutionized anesthetic practice by providing muscle relaxation with faster onset, a more rapid measurable recovery. Cisatracurium is a recently introduced benzylisoquinolinium non-depolarizing neuromuscular drug which is a stereoisomer of Atracurium and constitutes about 15% of the commercially produced Atracurium and with a potency of three to four times greater than that of Atracurium.  Materials and methods: This single center study was conducted in the Department of Anesthesiology at Maheshwara Medical College and Hospital over a period of 1 year. A total of 120 patients, 18-60 years of age. Patients were randomly divided into two groups; Group C received cisatracurium 0.1 mg/kg as muscle relaxant and Group A received atracurium 0.3 mg/kg IV. The mean onset time and duration of action for the two groups was done by Stockholm rules of the pharmacodynamic investigations of muscle relaxants activity. Intubating conditions, hemodynamic changes, and safety profile were noted. Result: In atracurium group, easy jaw opening was seen in 41 patients Comparatively in Cisatracurium group, jaw opening was easy in 45 patients and moderate in five patients. There was no statistically significant difference between two groups (P>0.05). In Group A, vocal cords were found in moving condition in about 35 patients while in 25 patients they were open, easing the intubation. In Group CA, vocal cords movement was seen in Twenty patients. It was found that vocal cord relaxation was better in Group CA, which was statistically significant (P<0.05). In Group A, 34 patients had slight diaphragmatic movement and 16 patients showed complete relaxation. However, in Group CA, 38 patients showed complete relaxation and only seven patients had mild cough reflex.  Conclusion: It can be concluded that intubating conditions are better with 3ED95 dose of cisatracurium as compared to 2ED95 dose of atracurium. None of the participant showed signs of histamine release. Hence, cisatracurium can be considered as more efficacious as compared to atracurium.