Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Cisatracurium besilate
General information
Cisatracurium is one of the ten isomers of atracurium. With an ED 95 of 0.05 mg/kg it is about three times more potent than atracurium [ ]. The duration of action of cisatracurium tends to be slightly longer than that of atracurium. Less cisatracurium is required to achieve a given degree of neuromuscular blockade and so less laudanosine is produced.
Cisatracurium and atracurium share the same metabolic pathways, but Hofmann elimination may have a greater role in the elimination of cisatracurium than in atracurium [ , ]. Spontaneous in vivo degradation accounts for 77% of total body clearance of cisatracurium [ ]. Organ clearance is 23% of total body clearance. Major metabolites of cisatracurium are laudanosine and a monoquaternary acrylate.
Clinical problems due to histamine release after bolus administration of cisatracurium have not been observed, even with very large doses up to 0.4 mg/kg, but in some patients there were considerable increases in plasma histamine concentrations [ ].
Organs and systems
Cardiovascular
With doses up to eight times the ED 95 no cardiovascular adverse effects were observed [ ] and in other studies cisatracurium had only minor cardiovascular adverse effects [ , , ]. Patients with coronary artery disease undergoing myocardial revascularization tolerated cisatracurium doses up to several fold the ED 95 well; hemodynamic changes from pre- to postinjection were minimal [ , ].
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here