Atracurium versus cisatracurium: A comparison of efficacy and safety of intubating dose in adult surgical patients

Background: Our study investigated and compared the properties of atracurium and cisatracurium, nondepolarizing neuromuscular blocking agents from the benzylisoquinolinium group. Both of these agents exhibit an intermediate duration of action. We studied the onset of neuromuscular blockade, intubating conditions, hemodynamic stability, and recovery following intubating doses. Materials and Methods: We conducted a study involving 40 patients undergoing general anesthesia, randomly assigned to two groups. Group A, consisting of 20 patients, received a dose of 0.6 mg/kg of atracurium, while Group C, also with 20 patients, received 0.15 mg/kg of cisatracurium. Throughout the surgery, we observed and recorded the time of onset of neuromuscular blockade, the intubating conditions, and the recovery following the administration of the first dose of neuromuscular blocking agents. Additionally, we continuously monitored the patient’s hemodynamic status until they recovered from the initial dose. Results: Group C exhibited a significantly faster onset of action (231.5 ± 31.2 s) than Group A (291.0 ± 14.1 s) for the administered neuromuscular blocking agents. The recovery duration following the intubating dose was notably shorter in Group A (31 ± 6.20 min) compared to Group C (50.5 ± 3.20 min). Additionally, in the cisatracurium group, all patients (100%) achieved “excellent” intubating conditions, whereas in the atracurium group, this was only the case for 60% of patients, and this difference was statistically significant. Furthermore, the atracurium group showed significantly higher heart rate and mean arterial pressure readings at different intervals than the cisatracurium group. Importantly, no adverse reactions were observed in any of the patients throughout the study. Conclusion: Compared to atracurium (0.6 mg/kg), cisatracurium at a dose of 0.15 mg/kg demonstrates superior effectiveness regarding the onset and duration of neuromuscular blockade and intubating conditions. Furthermore, cisatracurium offers a more favorable hemodynamic profile.