Comparison of the Onset of Action, Maintenance, and Recovery of Three Weight-based Dosing of Cisatracurium in Patients with Morbid Obesity in Laparoscopic Bariatric Surgery: A Randomized Clinical Trial | ||
| Iranian Journal of Medical Sciences | ||
| مقاله 5، دوره 48، شماره 6، بهمن و اسفند 2023، صفحه 563-571 اصل مقاله (685.4 K) | ||
| نوع مقاله: Original Article(s) | ||
| شناسه دیجیتال (DOI): 10.30476/ijms.2023.96131.2762 | ||
| نویسندگان | ||
| Faranak Rokhtabnak1؛ Saeed Safari2؛ Soudabeh Djalali Motlagh* 1؛ Toktam Yavari1؛ Elham Pardis1 | ||
| 1Department of Anesthesiology, Pain and Intensive Care Medicine, Firoozgar General Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran | ||
| 2Department of General Surgery and MIS, Firoozgar General Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran | ||
| چکیده | ||
| Background: For patients with morbid obesity, different cisatracurium dosage regimens are recommended. This study aimed to compare the onset of action, the sufficiency of neuromuscular blockade during infusion, and the recovery of the three distinct cisatracurium dosage scalars in patients with morbid obesity undergoing laparoscopic bariatric surgery. Methods: In this randomized clinical trial, 55 patients were scheduled for bariatric surgery at Firoozgar Hospital from March 2020 to August 2021. Using a block randomization method, they were randomly divided into three groups, based on total body weight (TBW group), fat-free mass (FFM group), or ideal body weight (IBW group), to receive a bolus of cisatracurium 0.2 mg/Kg, followed by an infusion of 2 µg/Kg, to maintain a train-of-four (TOF) count≤2. Data were analyzed using SPSS software. P<0.05 was considered statistically significant. Results: The mean time (seconds) to reach TOF0 in the TBW group was significantly shorter (201.89, 95%CI=192.99-210.79; P=0.004) than the IBW group (233.53, 95%CI=218.71-248.34; P=0.01). However, this difference was not statistically significant between TBW and FFM groups (220.83, 95%CI=199.73-241.94; P=0.81) or between FFM and the IBW groups (P=0.23). The rescue dose and increments of cisatracurium infusion were not required in the TBW group, whereas their probability was 4.81 times higher in the IBW group than the FFM group. Furthermore, the TBW and FFM groups had higher mean surgical condition scores than the IBW group (P<0.001, and P=0.006, respectively). Conclusion: Cisatracurium loading and infusion dosing based on FFM provide a comparable onset of action and surgical field condition to the TBW-based dosing with a shorter recovery time. However, IBW-based dosing of cisatracurium was insufficient for laparoscopic bariatric surgery. Trial Registration Number: IRCT20151107024909N9. | ||
تازه های تحقیق | ||
Faranak Rokhtabnak (Google Scholar) Soudabeh Djalali Motlagh (Google Scholar) | ||
| کلیدواژهها | ||
| Anesthesia؛ Bariatric surgery؛ Clinical trial؛ Morbid obesity | ||
| مراجع | ||
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