Comparative Study on Hemodynamic Effects of Cistracurium and Atracurium for Cesarean Section under General Anesthesia

OBJECTIVE To investigate effects of cisatracurium and atracurium on hemodynamic in cesarean section under general anesthesia. METHODS A total of 40 puerpera acceptance cesarean section under general anesthesia, ASA Ⅰ-Ⅱ grade, were randomly divided into two groups: group A and group C(n=20 respectively). Rapid sequence intubation was accomplished by intravenous propofol 2 mg·kg^-1 and succinylcholine 1.5 mg·kg^-1. Maintenance of muscle relaxation was achieved through intravenous atracurium 0.4 mg·kg^-1(group A), or intravenous cisatracurium 0.1 mg·kg^-1(group C). Blood pressure, heart rate(HR) and cardiac output index (CI), systemic vascular resistance index (SVRI), neonatal Apgar scores and umbilical arterial blood gas and other parameter were recorded at baseline values before induction(T₀), 3 min after injected of non-depolarizing muscle relaxant (T₁), the fetus removed immediately(T₂), 2 min after using oxytocin(T₃), the end of surgery(T₄), respectively. RESULTS Two groups of maternal intraoperative muscle relaxants were satisfied, with similar postoperative extubation time. After injection of non-depolarizing muscle relaxants, the blood pressure drop, the HR increased and SVRI declined in group A. Compared with the base value T₀, the differences of the SBP, DBP, MAP, HR at T₁, T₂ and T₃ and SVRI at T₁, T₂, T₃, T₄ were statistically significant(P<0.05 or P<0.01) in group A. Compared with the base value T₀, the difference of the DBP and MAP decreased at T₃ was statistically significant(P<0.05) in group C. The SBP, DBP, MAP values in group A was lower at T₁, T₂ and T₃ time points than in group C. The HR was faster in group A at T₁ than in group C; SVRI values of group A at T₁, T₂ and T₃ time points was lower than that in group C and the difference were statistically significant(P<0.05 or P<0.01). CI between the two groups and within the group had no significant difference(P>0.05). CONCLUSION General anesthesia for cesarean section using atracurium or cisatracurium can provide excellent muscle relaxant conditions, and can quickly recover after surgery. Comparing with atracurium, cisatracurium shows a smaller maternal hemodynamic change.