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
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.
Media Articles Related to Nimbex (Cisatracurium)
General Anesthesia May Negate Endovascular Benefit in Stroke
Source: Medscape Critical Care Headlines [2015.02.17]
Subgroup analysis of the MR CLEAN trial has shown that patients who underwent endovascular clot retrieval under general anesthesia did not show the benefit seen overall in the trial.
Medscape Medical News
The Death of Joan Rivers: Endoscopy and Anesthesia Risks
Source: MedicineNet Heart Attack Pathology: Photo Essay Specialty [2014.12.09]
Title: The Death of Joan Rivers: Endoscopy and Anesthesia Risks
Category: Doctor's Views
Created: 9/8/2014 12:00:00 AM
Last Editorial Review: 12/9/2014 12:00:00 AM
Parsing Out Best Practices for Endovascular Thrombectomy (CME/CE)
Source: MedPage Today Emergency Medicine [2015.02.16]
(MedPage Today) -- "Time is brain" in endovascular thrombectomy, more evidence against general anesthesia.
Published Studies Related to Nimbex (Cisatracurium)
Cisatracurium pretreatment with tourniquet reduces propofol injection pain: a
double-blind randomized controlled trial. 
with that of lidocaine... CONCLUSIONS: 0.15 mg/kg cisatracurium effectively decreases the incidence and
[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.
Clinical Trials Related to Nimbex (Cisatracurium)
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.
Effect of Laparoscopic Operation on Rocuronium and Cisatracurium: Pharmacokinetic and Pharmacodynamic Analysis [Not yet recruiting]
The investigators investigated whether laparoscopic versus open surgical approaches affected
the pharmacokinetic and pharmacodynamic of a single bolus dose of rocuronium or
Study of Cisatracurium and Sufentanil Consumption Using a Closed Loop Computer Control Infusion System [Recruiting]
When Cooling a Patient After Cardiac Arrest, Does Use of a Neuromuscular Blocking Agent Make Your Job Easier? [Not yet recruiting]
After successful resuscitation from cardiac arrest, cooling the whole body is a well
established treatment that improves the chances of the brain recovering. This however, has
to be done within a certain time-frame from the arrest. The purpose of this study is to
explore the best way of dosing the muscle relaxing medications that are given during the
Hypothesis: In the context of our institutional therapeutic hypothermia protocol,
cisatracurium infusions lead to faster drops in core temperature when compared to
cisatracurium prn boluses alone.
Reports of Suspected Nimbex (Cisatracurium) Side Effects
Drug Ineffective (11),
Anaphylactic Shock (6),
Sinus Tachycardia (5),
Blood Pressure Decreased (4),
Anaphylactic Reaction (2), more >>