Exploration of cisatracurium for tracheal intubation with the best priming and intubation dose

Objective To observe different priming techniques with intubation dose when using cisatracurium in onset time and safety. Methods Eighty ASA physical status Ⅰ and Ⅱ patients undergoing elective surgery requiring general anesthesia were enrolled. Group Ⅰ with 20 cases received cisatracurium 0.010 mg/kg, group Ⅱ with 20 cases received cisatracurium 0.015 mg/kg,group Ⅲ with 20 cases received cisatracurium 0.010 mg/kg,and group Ⅳ with 20 cases received normal saline. Four minutes after priming,group Ⅰ received cisatracurium 0.140 mg/kg ,group Ⅱ received cisatracurium 0.135 mg/kg, group Ⅲ received cisatracurium 0.190 mg/kg,and group Ⅳ received cisatracurium 0.200 mg/kg. Mechanomyography assessed the neuromuscular function of the adductor pollicis with train-of-four (TOF) supramaximal impulses T1. The trachea was intubated when the amplitude of T1 decreased to 0. Recorded T1 and TOF in 4 minutes and onset time of muscle relaxation, then evaluated intubation condition. Results The onset time in group Ⅰ , Ⅱ, Ⅲ and Ⅳ were (151.30 ± 10.90), (138.90 ±8.37), (145.45 ± 17.12), (148.75 ± 18.70) s,respectively. The onset time in group Ⅱ was obviously shorter than that in group Ⅰ , Ⅲ and Ⅳ (P ＜ 0.01 ),thus there was no significant differences among the group Ⅰ , Ⅲ and Ⅳ. During the priming interval, the value of T1 and TOF were both showing downtrend, in group Ⅱ ,there was TOF ＜ 90%. Conclusions Priming dose 0.010 mg/kg and intubation dose 0.140 mg/kg is just the same like that in intubation dose of quadruple ED95 whether priming. There is no benefit in priming cisatracurium of intubation dose quadruple ED95. There is TOF ＜ 90% in 4 minutes priming interval when using priming dose 30% ED95 and it is proved unsafely. Key words: Acurium;  Safety;  Priming;  Onset time