The cerebral and cardiovascular effects of cisatracurium and atracurium in neurosurgical patients

Anesthesia and Analgesia
W M SchrammU Illievich

Abstract

Drugs for neurosurgical patients should not increase intracranial pressure (ICP) or change cerebral perfusion pressure (CPP) and cerebral blood flow. This double-blind, cross-over study compares the effects of a single (3 x effective dose producing 95% twitch depression) intravenous bolus dose of cisatracurium 0.15 mg/kg with atracurium 0.75 mg/kg on mean red blood cell flow velocity in the middle cerebral artery (CBFV; transcranial Doppler), ICP (intraventricular or intraparenchymal monitor), mean arterial pressure (MAP), CPP (MAP-ICP), and heart rate (HR) every minute during a 15-min study period. Included in the study were 14 sedated and ventilated adult neurosurgical patients. After the cisatracurium bolus, ICP, CPP, CBFV, MAP, and HR did not change, and no histamine related events were observed. After the atracurium bolus, ICP, CPP, CBFV, and MAP decreased. The lowest values of ICP (-16% of baseline), CPP (-5%), CBFV (-8%), and MAP (-7%) were recorded 2-4 min after the atracurium bolus injection. After this transient decrease, MAP and CPP returned to baseline, whereas CBFV and ICP transiently exceeded baseline values. The highest values of CBFV (5%) and ICP (17%) were recorded 9-12 min after the atracurium bolus injection....Continue Reading

References

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Citations

May 26, 2009·Indian Journal of Pediatrics·Sunit C Singhi, Lokesh Tiwari
Jun 1, 2005·Annales Françaises D'anesthèsie Et De Rèanimation·N BruderA de Kersaint-Gilly
Feb 6, 2002·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·UNKNOWN American College of Critical Care Medicine of the Society of Critical Care Medicine, American Society of Health-System Pharm
Jun 5, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Folafoluwa O. OdetolaJoseph R. Custer
Oct 22, 2008·Journal of Clinical Anesthesia·WangNing ShangGuanFang Gao
Jul 4, 2008·Annales Françaises D'anesthèsie Et De Rèanimation·F Lagneau
Jun 3, 2008·Neurologic Clinics·Leonardo Rangel-CastillaClaudia S Robertson
Jan 24, 2007·Critical Care Clinics·Leonardo Rangel-Castillo, Claudia S Robertson
Apr 9, 2016·International Journal of Molecular Sciences·Haixia ZhuangLiangqing Zhang
Jul 3, 2002·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kate Leslie, Sally Troedel
Sep 4, 2014·Neurocritical Care·Filippo SanfilippoMarc O Maybauer

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