Comparison of Cisatracurium and Atracurium on Hemodynamic Status and Neuromuscular Blockade During Elective Abdominal Surgeries

Maryam Shabbir; Muhammad Aatir Fayyaz; Muhammad Adnan

doi:10.54112/bcsrj.v6i2.2321

Authors

Maryam Shabbir Department of Anaesthesia, Nishtar Hospital Multan, Pakistan
Muhammad Aatir Fayyaz Department of Anaesthesia, Nishtar Hospital Multan, Pakistan
Muhammad Adnan Department of Anaesthesia, Nishtar Hospital Multan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i2.2321

Keywords:

Neuromuscular Blocking Agents; Atracurium; Cisatracurium; Hemodynamics; Surgical Procedures, Operative

Abstract

Atracurium and cisatracurium are commonly used non-depolarizing neuromuscular blocking agents during general anesthesia. Their comparative effects on onset of complete neuromuscular blockade and early hemodynamic stability remain clinically relevant in elective abdominal surgery. Objective: To compare cisatracurium and atracurium in terms of hemodynamic status and time to achieve complete neuromuscular blockade among patients undergoing elective abdominal surgeries. Methods: This randomized controlled trial was conducted in the Department of Anesthesia, Nishtar University Hospital, Multan, Pakistan, from December 2023 to December 2024. A total of 278 ASA-I patients aged 18–50 years undergoing elective abdominal surgery under general anesthesia were included. Patients were divided into two equal groups: Group A received atracurium 0.5 mg/kg, while Group B received cisatracurium 0.2 mg/kg. Neuromuscular blockade was assessed using train-of-four monitoring. Heart rate and mean arterial pressure were recorded at baseline and at one-minute intervals for 10 minutes after drug administration. Data were analyzed using SPSS version 23, and p<0.05 was considered statistically significant. Results: The mean age of patients was 35.42 ± 7.03 years, and 151 (54.3%) were male. Baseline demographic and operative characteristics were comparable between the groups. Cisatracurium produced significantly faster complete neuromuscular blockade than atracurium, with a mean time to TOF score 0 of 169.12 ± 16.17 seconds versus 186.16 ± 13.77 seconds, respectively (p<0.001). A higher proportion of patients in the cisatracurium group achieved TOF score 0 within 180 seconds compared with the atracurium group (76.3% vs 33.1%, p<0.001). Atracurium was associated with a mild early rise in heart rate and greater early reduction in mean arterial pressure, while cisatracurium showed better early hemodynamic stability. Conclusion: Cisatracurium was superior to atracurium in achieving earlier complete neuromuscular blockade with more stable early hemodynamic response.

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