Influence of acute normovolaemic haemodilution on the dose-response relationship and time course of action of cisatracurium besylate |
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Authors: | Dahaba A A Wang G Xu X Liu X Wu X Bornemann H Metzler H |
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Affiliation: | 1 Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria 2 Department of Anaesthesiology, Peking University First Hospital, Beijing, People's Republic of China |
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Abstract: | BACKGROUND: Acute normovolaemic haemodilution (ANH) is an efficacious bloodconservation strategy aiming at avoiding allogeneic blood transfusion.ANH was shown to increase the potency of vecuronium, atracurium,and rocuronium. The aim of our study was to investigate whethercisatracurium potency is altered with ANH. METHODS: Using the Relaxometer mechanomyograph, we compared cisatracuriumdoseresponse relationship and time course of action in60 patients randomly allocated to the ANH or control groups.Patients in each group were randomly allocated to receive oneof three cisatracurium doses (30, 40, 50 µg kg1)followed by a second supplemental dose to reach a total of 100 µg kg1. RESULTS: ANH did not result in a significant shift in cisatracurium logdoseprobit doseresponse curve. There was no significantdifference in mean (95% confidence intervals) ED50, ED90, andED95 (effective doses required for 50, 90, and 95% first twitchdepression) between the ANH group [29.5 (2732), 50.4(47.453.4), 58.7 (55.362) µg kg1]and the control group [28.2 (25.331), 47.6 (44.950.3),55.3 (52.558.1) µg kg1], whereasthere was no difference in mean (SD) Dur25 and Dur0.8 (timeuntil 25% first twitch and 0.8 train-of-four ratio recoveries)between the ANH group [40.8 (5.9), 64.7 (8.4) min] and the controlgroup [42.2 (7.6), 66.5 (10.7) min]. CONCLUSIONS: Our results demonstrated that unlike other previously reportedneuromuscular blocking drugs, ANH did not alter cisatracuriumpotency. Thus, cisatracurium would be the neuromuscular blockingdrug of choice in patients who undergo surgery with ANH, asno dose adjustments are required. |
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Keywords: | monitoring neuromuscular block neuromuscular blocking agent |
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