Assessing the Effect of Eliminating Maintenance Dose of Atracurium during Coronary Artery Bypass Graft Surgery

Objective: Comparing the effect of using a single intubation dose of Atracurium to a single intubation dose plus a maintenance infusion dose during coronary artery bypass graft surgery Methods and Main Results: 100 patients with a mean age of 55 ± 13.5 years (range 18 to 75 years undergoing elective Coronary Artery Bypass Graft surgery were evaluated in two different groups, group B(50 persons) used bolus dose of Atracurium and group M (50 persons) received the intubation plus Maintenance doses of Atracurium. Patients were compared by demographic, hemodynamic, probable diaphragmatic movement during the surgery, extubation time and ICU staying time. Mean systolic blood pressure had statistically significant differences between two groups; however, these differences seemed to be clinically unimportant. ICU stay was also significantly different between the two groups. It was observed that the mean time of surgery was shorter in “B” in than “M” group, which differed statistically significant that was not totally depending on anesthesiology management. Conclusions: Atracurium bolus intubation dose could be used in cardiac surgery instead of maintenance infusion dose and it facilitates reduction of patients ICU staying and costs, but requires monitoring of the depth of anesthesia and neuromuscular blockade throughout the operation time to avoid patient movement and awareness.