Influences Of Priming Technique On The Onset Time And Recovery Time-course Of Cisatracurium In Adults

Objective:To compare the effect of three different priming doses and two different priming intervals with the standard intubating dose of cisatracurium on the onset time,intubation conditions and recovery time-course.Methods:A prospective randomized study with 84 adult ASA GradeⅠ～Ⅱpatients,scheduled for elective surgery.General anesthesia was induced with midazolam-etomidate-fentanyl,after the patients lost their consciousness,neuromuscular function was assessed by train-of-four (TOF) stimulation of accelerometry.All patients were randomly divided into seven groups.Groupâ… received a placebo injection followed 6 min later by cisatracurium 0.15mg/kg.Groupâ…¡₁ andâ…¡₂ received a priming dose of cisatracurium 0.005mg/kg followed 3 min and 6 min later by cisatracurium 0.145mg/kg.Groupâ…¢₁ andâ…¢₂ was given a priming dose of 0.01mg/kg followed 3 min and 6 min later by a cisatracurium injection of 0.14mg/kg,where Groupâ…£₁ andâ…£₂ received a priming dose of 0.015mg/kg followed 3 min and 6 min later by administration 0.135mg/kg.The trachea was intubated after 95%suppression of the twitch tension.TOFR at the end of priming interval,the onset time of neuromuscular blockade,clinically acceptable intubation conditions and recovery time-course were obtained in all patients. RESULTS:(1) Priming technique speeded up the onset of cisatracurium(P＜0.05).The onset time was much shorter when the priming dose was larger or the priming interval was longer(P＜0.05).(2) TOFR at the end of priming interval was significantly depressed in priming 0.015mg/kg groups(P＜0.05),there was no difference on intubation conditions and recovery time-course in all groups(P＞0.05).CONCLUSION:Priming technique is effective when rapid tracheal intubation with cisatracurium was necessary.The degree of this effect relates closely to the priming dose and priming interval.