Anesthetic Effects on Partial Neuromuscular Blockade with Continuous Cisatracurium Infusion in Neurosurgery

Aim To investigate the infusion characteristics of cisatracurium when maintaining a long-time stable level of partial neuromuscular blockade(NMB) under sevoflurane-based or propofol TCI-based anesthesia in neurosurgery.Methods 40 patients undergoing neurosurgery were randomly assigned to receive a sevoflurane-based(sevoflurane group) or propofol TCI-based anesthesia(propofol group).Anesthesia was maintained with 1.0 MAC sevoflurane in sevoflurane group while target concentration of propofol was set at 4 μg.mL-1 in propofol group.Intraoperative continuous infusion of cisatracurium was performed.Infusion rate was titrated according to the NMB monitoring results to maintain a stable target NMB level(count of 2 of train of four,TOF).Results All the forty patients could achieve a stable NMB level of count of 2 in TOF mode for more than 2 hours,however,unexpected body movements were seen in two patients in Group P at such NMB level.Both of groups showed a progressive decrease in infusion requirements in two hours.Linear correlation between infusion rates and the time was found in both of groups.Conclusion In prolonged neurosurgery with either sevoflurane-based or propofol-based anesthesia,linear correlation between infusion rates and the time(120 min) was seen when maintaining a stable NMB level of count of 2 in TOF mode under continuous cisatracurium infusion.