Drug Index


Mechanism :

Cisatracurium Besylate binds to the nicotinic acetylcholine (cholinergic) receptors in the motor endplate and blocks access to the receptors. In the process of binding, the receptor is actually activated - causing a process known as depolarization. Since it is not degraded in the neuromuscular junction, the depolarized membrane remains depolarized and unresponsive to any other impulse, causing muscle paralysis.

Indication :

  • Adjunct to general anaesthesia provide skeletal muscle relaxation.

Contraindications :

Hypersensitivity to cisatracurium (or benzyl alcohol if 10 mL vial is used).

RSI (due to intermediate onset).

Dosing :

Neuromuscular blockade:
1-24 months:
0.15 mg/kg IV over 5-10 seconds during halothane/opioid anaesthesia.
2-12 years:
0.1-0.15 mg/kg IV over 5-15 seconds during halothane/opioid anaesthesia.
IV infusion (During extended surgery):
<2 years:
Safety and efficacy not established.
>2 years:
3 mcg/kg/min post IV bolus (for prevention of rapid spontaneous recovery of NM blockade), followed by 1-2 mcg/kg/min of maintenance dose (dose range of 0.5-10 mcg/kg/min).
Infusion rate to be decreased by 30-40% in case given during stable isoflurane or enflurane anaesthesia.

Adverse Effect :

Histamine release associated bradycardia and bronchospasm, flushing, hypotension, rash.

Interaction :

Aminoglycosides: May potentiate, prolong neuromuscular blockade.

Hepatic Dose :

No dosage adjustments are recommended.
11/01/2020 12:35:57 Cisatracurium
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