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Nimbex (Cisatracurium Besylate) - Summary

 
 



NIMBEX SUMMARY

NIMBEX (cisatracurium besylate) is a nondepolarizing skeletal muscle relaxant for intravenous administration. Compared to other neuromuscular blocking agents, it is intermediate in its onset and duration of action. Cisatracurium besylate is one of 10 isomers of atracurium besylate and constitutes approximately 15% of that mixture. Cisatracurium besylate is [1 R -[1α,2α(1' R *,2' R *)]]-2,2'-[1,5-pentanediylbis[oxy(3-oxo-3,1-propanediyl)]]bis [1-[(3,4-dimethoxyphenyl)methyl]-1,2,3,4-tetrahydro-6,7-dimethoxy-2-methylisoquinolinium] dibenzenesulfonate.

NIMBEX is an intermediate-onset/intermediate-duration neuromuscular blocking agent indicated for inpatients and outpatients as an adjunct to general anesthesia, to facilitate tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation in the ICU.


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NEWS HIGHLIGHTS

Media Articles Related to Nimbex (Cisatracurium)

Study finds low hand hygiene compliance rates during anesthesia administration
Source: Pain / Anesthetics News From Medical News Today [2014.07.02]
Anesthesia providers are missing opportunities to clean their hands during surgical procedures, according to a study published in the American Journal of Infection Control, the official publication...

Use of regional anesthesia during hip fracture surgery not associated with lower risk of death
Source: Pain / Anesthetics News From Medical News Today [2014.06.24]
Among more than 56,000 adults undergoing hip repair between 2004 and 2011, the use of regional anesthesia compared with general anesthesia was not associated with a lower risk of death at 30 days...

After anesthesia the brain 'reboots' itself to consciousness
Source: Pain / Anesthetics News From Medical News Today [2014.06.20]
One of the great mysteries of anesthesia is how patients can be temporarily rendered completely unresponsive during surgery and then wake up again, with their memories and skills intact.

Anesthesia May Harm Children's Brains
Source: MedicineNet Ear Tubes Specialty [2012.08.20]
Title: Anesthesia May Harm Children's Brains
Category: Health News
Created: 8/20/2012 11:00:00 AM
Last Editorial Review: 8/20/2012 12:00:00 AM

Hydroxyethyl starch in resuscitation fluid has direct harmful effects on kidney cells
Source: Urology / Nephrology News From Medical News Today [2014.07.14]
The increased risk of kidney injury related to the use of hydroxyethyl starch (HES) in resuscitation fluids reflects the mass of HES molecules, according to a report in Anesthesia & Analgesia...

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Published Studies Related to Nimbex (Cisatracurium)

[Comparison of atracurium, cisatracurium and vecuronium during anaesthesia for laparoscopic surgery]. [2011.01]
BACKGROUND: The aim of the study was to compare the intubating conditions, onset time, and duration of action of atracurium, cisatracurium, and vecuronium, when used for muscle relaxation in laparoscopic surgery with carbon dioxide inflation. In trying to find an "ideal" relaxant we compared the relative potency of these drugs, and also measured pH, PaCO2 and skin temperature... CONCLUSIONS: Vecuronium, besides providing excellent conditions for tracheal intubation, had the fastest onset time and optimal duration of action. We found the drug to be the most suitable for laparoscopic surgery.

Effect of an intravenous infusion of lidocaine on cisatracurium-induced neuromuscular block duration: a randomized-controlled trial. [2010.11]
BACKGROUND: Intravenous lidocaine can be used intraoperatively for its analgesic and antihyperalgesic properties but local anaesthetics may also prolong the duration of action of neuromuscular blocking agents. We hypothesized that intravenous lidocaine would prolong the time to recovery of neuromuscular function after cisatracurium... CONCLUSIONS: No significant prolongation of spontaneous recovery of a TOF ratio >/= 0.9 after cisatracurium was found in patients receiving intravenous lidocaine. (c) 2010 The Authors. Journal compilation (c) 2010 The Acta Anaesthesiologica Scandinavica Foundation.

Effect of an intravenous infusion of lidocaine on cisatracurium-induced neuromuscular block duration: a randomized-controlled trial. [2010.09.14]
Background: Intravenous lidocaine can be used intraoperatively for its analgesic and antihyperalgesic properties but local anaesthetics may also prolong the duration of action of neuromuscular blocking agents. We hypothesized that intravenous lidocaine would prolong the time to recovery of neuromuscular function after cisatracurium...

Cisatracurium in different doses versus atracurium during general anesthesia for abdominal surgery. [2010.09]
BACKGROUND: Cisatracurium in clinical practice is devoid of histamine-induced cardiovascular effects. On the other hand, 2 ED(95) doses of cisatracurium (100 micro g/kg) do not create satisfactory intubating conditions such as those seen with equipotent doses of atracurium. The recommended intubating dose of cisatracurium is 3 ED(95). To understand this discrepancy better, we evaluated the potency and onset of atracurium and cisatracurium... CONCLUSION: The same dose (2xED(95) dose) atracurium is more effective neuromuscular blocking agent than cisatracurium, while higher doses of cisatracurium 4xED(95) and 6xED(95) provide more effective, more rapid neuromuscular blocking with longer duration of action, stable hemodynamic status, and no associated signs of histamine release clinically.

Effect of nitrous oxide on cisatracurium infusion demands: a randomized controlled trial. [2010.08.18]
ABSTRACT: BACKGROUND: Recent studies have questioned our previous understanding on the effect of nitrous oxide on muscle relaxants, since nitrous oxide has been shown to potentiate the action of bolus doses of mivacurium, rocuronium and vecuronium. This study was aimed to investigate the possible effect of nitrous oxide on the infusion requirements of cisatracurium... CONCLUSIONS: Nitrous oxide does not affect the infusion requirements of cisatracurium. TRIAL REGISTRATION: ClinicalTrials.gov NCT01152905; European Clinical Trials Database at http://eudract.emea.eu.int/2006-006037-41.

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Clinical Trials Related to Nimbex (Cisatracurium)

Study of Cisatracurium and Sufentanil Consumption Using a Closed Loop Computer Control Infusion System [Recruiting]

Comparison Between Cisatracurium and Rocuronium in Terms of Recovery of the Muscular Strength in the Postoperative Phase After Surgery and General Anaesthesia [Recruiting]

Comparison of the Effects of Vecuronium and Cisatracurium on Electrophysiologic Monitoring During Neurosurgery [Recruiting]
Recently intraoperative motor evoked potential monitoring (MEP) is widely used to reduce neural damage during neurosurgery.

As neuromuscular blockade(NMB) during MEP monitoring decreases the amplitude of MEP, partial NMB is usually maintained during general anesthesia. Continuous infusion of NMB agent is preferred than bolus infusion during MEP monitoring. There are a lot of NMB agents in clinical use. But there have been no reports about the effect of changing NMB agent on efficacy of MEP monitoring.

Therefore, the investigators performed a randomized controlled trial to evaluate the effect of changing NMB agent on the variability of MEP amplitude during neurosurgery.

Comparison of Rocuronium and Org 25969 With Cisatracurium and Neostigmine [Completed]
The purpose of this study was to demonstrate in adult patients a faster recovery from a neuromuscular block with 2. 0 mg/kg Org 25969 (sugammadex) after rocuronium as compared to 50 ug/kg neostigmine after cisatracurium when administered at reappearance of T2

Effects of Neuromuscular Blocking Agents (NMBA) on the Alteration of Transpulmonary Pressures at the Early Phase of Acute Respiratory Distress Syndrome (ARDS) [Recruiting]
Mortality in Acute Respiratory Distress Syndrome is high (40 to 60 %). Protective mechanical ventilation, until 2010, was the cornerstone of the ARDS therapeutic strategies. Recently, a prospective multicenter study demonstrates that a 48h continuous infusion of neuromuscular blocking agents (NMBA) have a positive impact on mortality of ARDS patients. (Papazian et al. ACURASYS Study. NEJM 2010; 363: 1107-16). The mechanisms through which NMBAs could improve survival remain speculative. They are as follows:

- reduction of the consumption of oxygen linked to ventilatory workload;

- increase of chest wall compliance improving mechanical ventilation during ARDS and

better adaptation to the protective ventilation strategy;

- anti-inflammatory effect contributing to a reduction in pulmonary inflammation and

improvement in oxygenation,

- reduction of the variations of transpulmonary pressure (TPP) by the way of better

synchronisation between patient and the ventilator.

The use of NMBA could also reduce the ventilator induced lung injury by a better control of TPP.

more trials >>

Reports of Suspected Nimbex (Cisatracurium) Side Effects

Drug Ineffective (11)Anaphylactic Shock (6)Erythema (6)Angioedema (6)Dysarthria (5)Sinus Tachycardia (5)Hypotension (4)Blood Pressure Decreased (4)Tachycardia (3)Anaphylactic Reaction (2)more >>


Page last updated: 2014-07-14

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