Key result
Cisatracurium improves hemodynamic stability over atracurium during CABG induction in low-EF patients.
Why the study?
The comparative hemodynamic stability of cisatracurium versus atracurium in patients with low ejection fraction undergoing coronary artery bypass grafting was not established.
Does cisatracurium improve hemodynamic stability compared to atracurium in patients with low ejection fraction undergoing CABG?
RCT (n=80)
Lottery method
No
Does cisatracurium improve hemodynamic stability compared to atracurium in patients with low ejection fraction undergoing CABG?
Absolute Event Rate: 68.22% vs 72.2%
p-value: p=0.032
Cisatracurium provides more stable hemodynamic indices compared to atracurium during anesthesia induction in patients with low ejection fraction undergoing CABG.
May favor cisatracurium over atracurium for induction in low-EF CABG; confirms hemodynamic stability advantage in this RCT.
Objective: To compare the hemodynamic stability with cisatracurium and atracurium in patients with low ejection fraction undergoing coronary artery bypass grafting. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Anesthesiology, Army Cardiac Center, Lahore, from Jan 2018 to Nov 2018. Methodology: A total of 80 adult patients were recruited or invited to participate in this study. Further the cohort was divided in to two groups with respect to their treatment by draw method. Group I contained a total of 40 patients, which were given Cisatracurium 0.2mg/kg at induction of anesthesia. The group II patients constitute the same number but the treatment medication given was 0.5mg/kg Atracurium at induction. Results: Before anesthesia induction, pulse rate was 84.10 ± 5.54 bpm and 83.01 ± 5.72 bpm in group A and B, respectively (p=0.385). At 4 minutes after anesthesia induction, pulse rate was 83.05 ± 5.58 bpm and 86.37 ± 6.62 bpm in group A and B, respectively (p=0.017). Before anesthesia induction, mean arterial pressure was 71.07 ± 7.62 mmHg and 69.22 ± 10.77 mmHg in group A and B, respectively (p=0.378). At 4 minutes after anesthesia induction, mean arterial pressure was 68.22 ± 8.17 mmHg and 72.20 ± 8.09 mmHg in group A and B, respectively (p=0.032) table-II. Conclusion: We may conclude from our study that although there is significant difference of the change in arterial blood pressure due to the both drugs. The group A was having more stable hemodynamic indexes where the drug administrated was Cisatracurium.
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Naseer et al. (2021) conducted an RCT in Low ejection fraction undergoing coronary artery bypass grafting (n=80). Cisatracurium vs. Atracurium 0.5mg/kg was evaluated on Mean arterial pressure at 4 minutes after anesthesia induction (p=0.032). Cisatracurium provided more stable hemodynamic indices compared to atracurium in patients with low ejection fraction undergoing CABG, with a mean arterial pressure of 68.22 mmHg vs 72.20 mmHg at 4 minutes post-induction (p=0.032).
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