Cordero-Escobar I, Parisi-López N, Espinaco-Valdés J, Pérez-Martínez G

Language: Spanish
References: 39
Page: 205-209
PDF size: 63.97 Kb.

ABSTRACT

Background: Myasthenia gravis is an autoimmune disease that interferes with normal neuromuscular function. Objectives: To identify any differences in neuromuscular function monitoring with various doses of cisatracurium in myasthenic patients. Patients and methods: We studied 30 adult patients, ASA I or II, [undergoing transsternal thymectomy]. Patients were divided into three groups, 10 patients each. Cisatracurium was given to Group I at 15% the dose for non-myasthenic patients (15 mg/kg) , to Group II at 20% the dose (20 mg/kg), and to Group III at 25% the dose (25 mg/kg). Neuromuscular function was monitored using accelerometry. Results: Intubation conditions were excellent. Results of neuromuscular function monitoring turned out higher with the usual dose recommended for these patients, i.e, 25 mg/kg, except for the index of maximum blockade. Average surgical time was 90 ± 2.3 min. In Group III, total blockade time was longer, so that, at the end of the procedure, average value of twitch height for Group I was 85.2 ± 0.3%, whereas for Group III it was 65.3 ± 0.5%, and T4/T1 was 85% for Group I and 45% for Group III. Such differences were statistically significant (p ≤ 0.05). Conclusion: Cisatracurium at 15 mg/kg turned out to have a clinical effectiveness similar to that of intermediate-action muscle relaxants at the time of extubation.

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