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Korean Journal of Anesthesiology 1998;34(2):273-279.
DOI: https://doi.org/10.4097/kjae.1998.34.2.273   
The Effects of Acid-Base Imbalance on the Cisatracurium-Induced Neuromuscular Blockade in the Cat.
Jong Hwa Lee, Mi Young Choi, Yon Hee Shim, Hyun Joeng Kwak, Sung Cheol Nam, Yang Sik Shin
1Department of Anesthesiology, YUMC, Korea.
2Department of Anesthesiology, Jeil Women's Hospital, Korea.
Abstract
BACKGROUND
Cisatracurium is a nondepolarizing muscle relaxant. It less likely release histamine and has better cardiovascular stability. It presumably undergoes pH and temperature- dependent, nonenzymatic chemical process, Hofmann reaction. In vitro studies, Hofmann reaction was enhanced with increasing pH, but, in vivo the influence of acid-base imbalance is not well defined.
METHODS
To evaluate the effects of acid-base imbalance on the neuromuscular blockade of cisatracurium in the cat, we induced acid-base imbalance and performed cumulative dose-response studies.
RESULTS
ED50 of the cisatracurium was significantly reduced in all groups. Dose-response curves from all acid-base imbalance groups did not have significant differences in slopes. But, all showed shift-to-left when compared with control curve, showing decreased ED50. Duration of action was not affected. Recovery index was significantly changed in respiratory and metabolic alkalosis.
CONCLUSIONS
It may be concluded that acid-base imbalance significantly augmented the potency of cisatracurium, but, changes of recovery index in this study may be resulted from systemic instability such as unstable hemodynamic state by the prolonged experiment.
Key Words: Acid-base equilibrium: imbalance; Animals: cats; Neuromuscular relaxants: cisatracurium; Pharmacodynamics: dose-response curve


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