Neuromuscular Blockade – Part 4
Cisatracurium is one of the more commonly used drugs for paralysis. It is a purified form of the atracurium. It has an onset of action of 3-5 minutes and causes neuromuscular blockade for 20 to 35 minutes. It is popular with
anesthesia professionals as it is effective as a constant infusion. In contrast to some neuromuscular blocking drugs the rate of spontaneous recovery is not affected by how long the infusion has been running.
Cisatracurium is eliminated largely by Hoffman degradation which is a chemical mechanism of elimination, with a small amount being eliminated by the kidneys. The organ independent clearance means that the drug can be used in patients with kidney or liver failure without an appreciable change in its neuromuscular blocking profile.
Two other advantages of cistracurium is that its effects are only marginally impacted by advanced age. Also, it is not associated with significant histamine-releasing effect. These means in part that even large infusions of the drug do not cause significant changes in cardiovascular functioning.
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