Pancuronium versus Cisatracurium on Extubation Time in Adult Coronary Artery Bypass Grafting Surgery

Background- Given the importance of the effect of muscle relaxants on extubation time in coronary artery bypass grafting patients, we sought to assess the difference in “time to extubation” and “intensive care unit length of stay” between the primary bolus doses of pancuronium and cisatracurium, without using maintenance doses during the operation. Methods- This double-blind clinical trial divided 110 patients into two equal groups, receiving either cisatracurium or pancuronium. The patients’ surgical and cardiopulmonary bypass variables were evaluated, and extubation time and ICU length of stay were compared between the two groups. Results- There was no difference between the two groups regarding the depth of anesthesia, train-of-four (TOF) scores at the beginning of anesthesia, and the surgical and cardiopulmonary bypass variables. However, the cisatracurium patients were extubated earlier and had shorter ICU length of stay than the pancuronium patients. Conclusion- An appropriate depth of anesthesia facilitates the administration of the induction dose of cisatracurium, which confers earlier extubation and shorter ICU length of stay in comparison to pancuronium (Iranian Heart Journal 2010; 11 (3):19-23).