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

Published Studies Related to Nimbex (Cisatracurium)

Cisatracurium pretreatment with tourniquet reduces propofol injection pain: a double-blind randomized controlled trial. [2014]
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.

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Clinical Trials Related to Nimbex (Cisatracurium)

Optimal Dose of Combination of Rocuronium and Cisatracurium [Completed]
BACKGROUND: The combinations of rocuronium and cisatracurium have a synergic effect. The investigators studied whether the prediction is possible to have a sufficient effect of reducing the dose when combining the two neuromuscular blocking agents through monitoring neuromuscular relaxation during surgery. METHODS: Each group were intubating dose group (Group I, n=27) combined Effective Dose (ED)95 rocuronium and ED95 cisatracurium, small amount reducing group (Group S, n=27) reduced 10% of each ED95 and large amount reducing group (Group L, n=27) reduced 20% of each ED95. Before patients arrived in the operating room, rocuronium and cisatracurium were prepared by a nurse who was not involved in this study. Each study drug was administrated to the patient and timer was started with TOF-Watch® monitoring. Train-of-four (TOF) of the ulnar nerve was used as setting of 2 Hz per 12 sec. The investigators checked time to TOF ratio=0 (Onset), time to 1st TOF ratio>25% (Duration 25%) and TOF 25-75% (recovery index) under total i. v. anesthesia (TIVA). One way ANOVA was used for statistical analysis (α=0. 05, β=0. 2).

Effects of Cisatracurium on Succinylcholine-induced Fasciculations and Myalgia [Completed]

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 cisatracurium.

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

Effects of Cisatracurium on Sccinylcholine-induced Fasciculations [Not yet recruiting]

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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 >>