Key result
Cisatracurium maintains QTc intervals ~18 ms shorter vs atracurium during surgery, stabilizing cardiac repolarization.
Why the study?
Muscle relaxants used during surgery may have differing impacts on ECG, potentially affecting cardiac safety.
Does Cisatracurium prevent QT interval prolongation compared to Atracurium in patients undergoing cataract surgery under general anesthesia?
RCT (n=80)
Double-blind
Random block method
No
Does Cisatracurium prevent QT interval prolongation compared to Atracurium in patients undergoing cataract surgery under general anesthesia?
Cisatracurium provides more stable cardiac repolarization with less QT prolongation compared to Atracurium during cataract surgery under general anesthesia.
Answers are grounded in this paper and cite their sources.
Cisatracurium may be preferred over atracurium to limit QTc prolongation risk during general anesthesia; extends comparative safety data on neuromuscular blockers.
BACKGROUND: Muscle relaxants are used during surgery, but their impact on ECG may differ, potentially affecting cardiac safety. This study aimed to compare the effects of Atracurium versus Cisatracurium on QT interval changes in patients undergoing cataract surgery. METHOD: This double-blind, parallel-group randomized clinical trial (RCT) was conducted in 2023 in Hamadan, Iran. A total of 80 patients undergoing cataract surgery under general anesthesia were randomly assigned to receive either Atracurium (n = 40) or Cisatracurium (n = 40). QT interval changes were measured at four time points to assess and compare the corrected QT interval (QTc) between the two groups. Data were analyzed using SPSS version 29, and a p-value < 0.05 was deemed significant. RESULTS: Cisatracurium demonstrated significant reductions in QTc from pre-anesthesia to post-anesthesia and through recovery, with values of -9.325 ms (P = 0.045), -9.925 ms (P = 0.038), and - 19.359 ms (P = 0.016), respectively. Atracurium also showed reductions but a notable increase in QTc after anesthesia to the end of surgery (32.322 ms, P = 0.0019). Throughout the procedure, Cisatracurium maintained shorter QTc intervals compared to Atracurium (e.g., T0: 420.07 ms vs. 434.75 ms, P = 0.03), but post-recovery, no significant differences were observed (Cisatracurium: 440.05 ms; Atracurium: 439.80 ms, P = 0.489). CONCLUSIONS: Atracurium causes more QT prolongation than Cisatracurium. While both affect QTc intervals, Cisatracurium has a more stable impact on cardiac repolarization, making it safer for patients at risk of QT prolongation. Cisatracurium's minimal impact on cardiovascular function, especially in patients with low ejection fraction, makes it the preferred choice for maintaining cardiac stability. TRIAL REGISTRATION: IRCT20120215009014N441.
No takes yet. Share an insight, caveat, or question.
Karimi et al. (2024) conducted an RCT in Cataract surgery under general anesthesia (n=80). Cisatracurium vs. Atracurium (0.25 mg/kg) was evaluated on QTc interval at the end of surgery (MD -17.5 ms, p=0.002). Cisatracurium maintained shorter QTc intervals during surgery compared to Atracurium, with a mean difference of -17.5 ms at the end of surgery, demonstrating a more stable impact on cardiac repolarization.
Synapse has enriched 10 related papers. Consider them for comparative context: