Neuromuscular Blocking Effect Of Cisatracurium In Patients With Liver Dysfunction For Obstructive Jaundice

Background Cisatracurium, one of the ten isomers in atracurium, is a nondepolarizing muscle relaxant with an intermediate duration of action .As one of the isomers composing atracurium, it presumably undergoes Hofmannn elimination . It is twice more potent and less likely to release histamine than atracurium, having almost no cardiovascular effect. It can be and having been widely used. So far,the neuromuscular blocking effect ,after a single bolus dose of cisatracurium in patients with obstructive jaundice, has not been found in any published papers. This research was going to evaluate the effect mentioned above, hoping to give contribution to its clinical use.Objective The purpose of this study was to evaluate the neuromuscular blocking effect after a single bolus dose of cisatracurium in patients with obstructive jaundice.Methods 30 patients undergoing abdominal region surgery were divided into two groups: obstructive jaundice group (group G) and control group (group C). The liver function of the patients in group G was classified as Child-Pugh grade B, while those in group C had no liver dysfunction. Anesthesia was induced with propofol by TCI ( blood plasma concentration set at 3μg/ml ),remifentanyl (blood plasma concentration set at 3-6ng ml ) ,cisatracurium 0.15mg/kg i.v.. The patients were intubated when the neuromuscular blockage came to maximum.Anesthesia was maintained with propofol and remifentanyl by TCI as induced. The response of adductor pollicis to stimulation was recorded. Results The two groups were comparable with respect to sex , age and BMI. The onset time of group G was significantly longer than in group C( p<0.01), while the maintenance time , recovery time and recovery index had no significant differences in both groups( p >0.05).Conclusion The onset of the neuromuscular blocking effect of cisatracurium is slower , while duration of action , recovery time and recovery index comparable in patients with liver dysfunction for obstructive jaundice.