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Cisatracurium versus vecuronium: a comparative, double blind, randomized, multicenter study in adult patients under propofol/fentanyl/N2O anesthesia.
Minerva Anestesiol. 2006 May; 72(5):299-308.MA

Abstract

AIM

The aim of this study was to compare the time course characteristics of cisatracurium (C) and vecuronium (V) induced neuromuscular block (NMB) following multiple doses, allowing spontaneous complete recovery (SCRT) and evaluating the influence of age.

METHODS

Following institutional approval and signed informed consent, 177 adult ASA 1-2 patients were included in a randomized, double-blind, multicenter study under N20/02/fentanyl/propofol anesthesia. Muscle relaxation was induced with 0.15 mg/kg C or 0.l mg/kg V and was maintained with 0.03 mg/kg of C or 0.02 mg/kg of V injected at T1 25% recovery. Intubating conditions were assessed at 2 min after the initial dose. Time course of NMB was monitored using accelerography (Tofguard) of the adductor pollicis with train-of-four (TOF). Data were analyzed with parametric (Anova) and non parametric statistics (c2, Kruskal Wallis).

RESULTS

Both drugs offered good/excellent intubating conditions: duration of action of NMB (mean values +/- SD, minutes) were: dur25 first dose: V 38.20+/-13.2 vs C 51.5+/-11.3 (P<0.02); dur25 following repeated boluses (average): V 23.2+/- 8.6 vs C 28.2+/-9.5, ns; dur25 last dose: V 25.1+/-11.5 vs C 31.5+/-11.4, ns: SCRT following last dose: V 50.2+/-23.2 vs C 46.4+/-17.5, ns: t125% to t4/T1 0.80:V 27.1+/-18.7 vs C 18.8+/-10.2, ns. Stratifying for age >or< 65 no differences were noted in the intervals studied following C, while all were longer following V. The duration of block of C was longer than V; the SCRT after the final dose of C was shorter than V albeit not significant. There was a clinically significant increase in duration of block and recovery time in elderly patients for V but not for C.

CONCLUSIONS

C and V allow predictable NMB duration and spontaneous recovery even if administered in multiple repeated doses; but in elderly patients duration of block and recovery time is longer following V.

Authors+Show Affiliations

Anestesia and Resuscitation Unit, City Hospital, Faenza (RA), Italy. mellons48@libero.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng ita

PubMed ID

16675938

Citation

Melloni, C, et al. "Cisatracurium Versus Vecuronium: a Comparative, Double Blind, Randomized, Multicenter Study in Adult Patients Under propofol/fentanyl/N2O Anesthesia." Minerva Anestesiologica, vol. 72, no. 5, 2006, pp. 299-308.
Melloni C, Devivo P, Launo C, et al. Cisatracurium versus vecuronium: a comparative, double blind, randomized, multicenter study in adult patients under propofol/fentanyl/N2O anesthesia. Minerva Anestesiol. 2006;72(5):299-308.
Melloni, C., Devivo, P., Launo, C., Mastronardi, P., Novelli, G. P., & Romano, E. (2006). Cisatracurium versus vecuronium: a comparative, double blind, randomized, multicenter study in adult patients under propofol/fentanyl/N2O anesthesia. Minerva Anestesiologica, 72(5), 299-308.
Melloni C, et al. Cisatracurium Versus Vecuronium: a Comparative, Double Blind, Randomized, Multicenter Study in Adult Patients Under propofol/fentanyl/N2O Anesthesia. Minerva Anestesiol. 2006;72(5):299-308. PubMed PMID: 16675938.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cisatracurium versus vecuronium: a comparative, double blind, randomized, multicenter study in adult patients under propofol/fentanyl/N2O anesthesia. AU - Melloni,C, AU - Devivo,P, AU - Launo,C, AU - Mastronardi,P, AU - Novelli,G P, AU - Romano,E, PY - 2006/5/6/pubmed PY - 2006/8/19/medline PY - 2006/5/6/entrez SP - 299 EP - 308 JF - Minerva anestesiologica JO - Minerva Anestesiol VL - 72 IS - 5 N2 - AIM: The aim of this study was to compare the time course characteristics of cisatracurium (C) and vecuronium (V) induced neuromuscular block (NMB) following multiple doses, allowing spontaneous complete recovery (SCRT) and evaluating the influence of age. METHODS: Following institutional approval and signed informed consent, 177 adult ASA 1-2 patients were included in a randomized, double-blind, multicenter study under N20/02/fentanyl/propofol anesthesia. Muscle relaxation was induced with 0.15 mg/kg C or 0.l mg/kg V and was maintained with 0.03 mg/kg of C or 0.02 mg/kg of V injected at T1 25% recovery. Intubating conditions were assessed at 2 min after the initial dose. Time course of NMB was monitored using accelerography (Tofguard) of the adductor pollicis with train-of-four (TOF). Data were analyzed with parametric (Anova) and non parametric statistics (c2, Kruskal Wallis). RESULTS: Both drugs offered good/excellent intubating conditions: duration of action of NMB (mean values +/- SD, minutes) were: dur25 first dose: V 38.20+/-13.2 vs C 51.5+/-11.3 (P<0.02); dur25 following repeated boluses (average): V 23.2+/- 8.6 vs C 28.2+/-9.5, ns; dur25 last dose: V 25.1+/-11.5 vs C 31.5+/-11.4, ns: SCRT following last dose: V 50.2+/-23.2 vs C 46.4+/-17.5, ns: t125% to t4/T1 0.80:V 27.1+/-18.7 vs C 18.8+/-10.2, ns. Stratifying for age >or< 65 no differences were noted in the intervals studied following C, while all were longer following V. The duration of block of C was longer than V; the SCRT after the final dose of C was shorter than V albeit not significant. There was a clinically significant increase in duration of block and recovery time in elderly patients for V but not for C. CONCLUSIONS: C and V allow predictable NMB duration and spontaneous recovery even if administered in multiple repeated doses; but in elderly patients duration of block and recovery time is longer following V. SN - 0375-9393 UR - https://www.unboundmedicine.com/medline/citation/16675938/Cisatracurium_versus_vecuronium:_a_comparative_double_blind_randomized_multicenter_study_in_adult_patients_under_propofol/fentanyl/N2O_anesthesia_ L2 - http://www.minervamedica.it/index2.t?show=R02Y2006N05A0299 DB - PRIME DP - Unbound Medicine ER -