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Original ArticleOpen Access
A Comparison of the Efficacy of Cisatracurium and Atracurium in Kidney Transplantation Operation
Jirasiritham S 
,
Tantivitayatan K ,
Jirasiritham S
,
Tantivitayatan K ,
Jirasiritham S SIRIW AN JIRASIRITHAM, MD*,
KAMTHORN TANTIVITA YATAN, MD*,
SOPON JIRASIRITHAM, MD**
Cisatracurium is a new intermediate-acting benzylisoquinolinium neuromuscular blocking
agent that is one of the ten stereoisomers contained in atracurium besylate. Atracurium is known to be
the muscle relaxant of choice in end stage renal disease patients. This study aimed to compare the
efficacy of cisatracurium and atracurium in the aspect of intubation and maintenance dosages, hemo-
dynamic response after intubation and cost effectiveness between the two agents in kidney transplant
patients.
Material and Method
: From August 2001 to July 2002, 46 end stage renal disease patients
obtained kidney transplantation operation under general anesthesia with 50 : 50
Np : 0
2
,
fentanyl,
isoflurane anesthesia. Tracheal intubation and maintenance of muscle relaxant with each drug were
administered in 23 of each group-atracurium as control (C) while cisatracurium was the study (S) group.
Results
: There was no difference in the demographic data of the 2 groups -13 males/10
females in the S group and 11 males/12 females in the C group. Eighty-seven per cent in the S group
underwent living-related kidney transplantation operation, with 55.56 per cent in the C group. Most of
the donors were siblings, i.e. 42.11 per cent in the S group and 46.67 per cent in the C group.
The mean dosage for intubation in the S group was 0.17
เธ‘
0.02 mg/kg and 1.25
เธ‘
0.49 J.lg/kg/
min for maintenance. The mean dosage for intubation in the C group was 0.64
เธ‘
0.07 mg/kg and the
mean maintenance dose was 5.38
เธ‘
0.83 J.lg/kg/min. In both groups there was no statistical difference in
hemodynamic changes. One patient in the S group received calcium channel blocker to reduce blood
pressure before induction of anesthesia, while 2 patients in the C group were given nifedipine 5 mg
before induction. Although the cisatracurium cost was higher than atracurium, from the cost-minimiza-
tion analysis, it turned out to be lower per case.
74
KAMTHORN TANTIVITA YATAN, MD*,
SOPON JIRASIRITHAM, MD**
Cisatracurium is a new intermediate-acting benzylisoquinolinium neuromuscular blocking
agent that is one of the ten stereoisomers contained in atracurium besylate. Atracurium is known to be
the muscle relaxant of choice in end stage renal disease patients. This study aimed to compare the
efficacy of cisatracurium and atracurium in the aspect of intubation and maintenance dosages, hemo-
dynamic response after intubation and cost effectiveness between the two agents in kidney transplant
patients.
Material and Method
: From August 2001 to July 2002, 46 end stage renal disease patients
obtained kidney transplantation operation under general anesthesia with 50 : 50
Np : 0
2
,
fentanyl,
isoflurane anesthesia. Tracheal intubation and maintenance of muscle relaxant with each drug were
administered in 23 of each group-atracurium as control (C) while cisatracurium was the study (S) group.
Results
: There was no difference in the demographic data of the 2 groups -13 males/10
females in the S group and 11 males/12 females in the C group. Eighty-seven per cent in the S group
underwent living-related kidney transplantation operation, with 55.56 per cent in the C group. Most of
the donors were siblings, i.e. 42.11 per cent in the S group and 46.67 per cent in the C group.
The mean dosage for intubation in the S group was 0.17
เธ‘
0.02 mg/kg and 1.25
เธ‘
0.49 J.lg/kg/
min for maintenance. The mean dosage for intubation in the C group was 0.64
เธ‘
0.07 mg/kg and the
mean maintenance dose was 5.38
เธ‘
0.83 J.lg/kg/min. In both groups there was no statistical difference in
hemodynamic changes. One patient in the S group received calcium channel blocker to reduce blood
pressure before induction of anesthesia, while 2 patients in the C group were given nifedipine 5 mg
before induction. Although the cisatracurium cost was higher than atracurium, from the cost-minimiza-
tion analysis, it turned out to be lower per case.
74
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