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British Journal of Anaesthesia, 2001, Vol. 86, No. 1 130-132
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Use of cisatracurium during fast-track cardiac surgery

A. Ouattara1, L. Richard1, J. M. Charrière1, H. Lanquetot1, P. Corbi2 and B. Debaene*,1

1Département d’Anesthésie-Réanimation and 2Service de Chirurgie Cardio-Thoracique, Centre Hospitalier Universitaire La Milétrie, Poitiers, France*Corresponding author: Département d’Anesthésie-Réanimation Chirurgicale, Centre Hospitalier Universitaire La Milétrie, 350 avenue Jacques Coeur, F-86021 Poitiers, France

We prospectively studied spontaneous recovery from cisatracurium-induced neuromuscular block in 18 patients scheduled for cardiac surgery, and its suitability for fast-track cardiac surgery. Neuromuscular block was induced by an i.v. bolus (range 0.15–0.3 mg kg–1) and maintained by a continuous infusion (range 1.1–3.2 µg kg–1 min–1) of cisatracurium until sternal closure. In the intensive care unit (ICU), spontaneous recovery was evaluated by the train-of-four (TOF) ratio measured at the adductor pollicis muscle. The ICU medical staff were unaware of the TOF ratios until sedation was stopped. At that time, if the TOF ratio was less than 0.9, sedation was recommenced. On arrival in ICU, all patients had residual paralysis. The mean time to reaching a TOF ratio of at least 0.9 was 102 min (range 74–144 min) after discontinuation of the cisatracurium infusion. Fifteen patients (83%) were successfully extubated during the first 8 h after stopping the cisatracurium infusion. Only one patient showed residual paralysis when sedation was discontinued. These results support the use of cisatracurium as a suitable neuromuscular blocking agent for fast-track cardiac surgery.

Br J Anaesth 2001; 86: 130–2


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