COMPARISON OF DURATION OF NEUROMUSCULAR BLOCKADE WITH ATRACURIUM IN OBESE PATIENTS

Neuromuscular Blockade With Atracurium

Abstract

Objective: To compare the mean duration of atracurium induced neuromuscular blockade in minutes when dosed according to real body weight (RBW) or ideal body weight (IBW) to obese patients undergoing abdominal surgeries under general anesthesia.
Study Design: Randomized controlled trial.
Place and Duration of Study: Department of Anesthesiology, National hospital defense Lahore, From March 2015 to March 2016.
Material and Methods: One hundred and fifty (150) patients were selected for this study and divided in to two equal groups (75 patients in each group), group-I (experimental group) and group-II (control group). Sample size was calculated with 80% power of test, 95% confidence interval taking mean and standard deviation of duration of atracurium induced neuromuscular blockade in minutes in both groups i.e. 74.6 ± 37.56 in real body weight group versus 40.02 ± 22.5 in ideal body weight group. Non probability consecutive sampling technique was used. SPSS version 16 was used for data analysis. Frequency and percentages were used to present categorical data and mean ± standard deviation for numerical data. Independent sample t-test was applied to compare the significance of outcome variables. A p-value of <0.05 was considered statistically significant.
Results: There was a prolong duration of action in experimental group (real body weight group) 69.64 ± 3.11 minute versus 46.33 ± 2.77 minute in control group (ideal body weight group) which suggests that dose of atracurium should be calculated and given on basis of ideal body weight in obese.
Conclusion: It was observed in our clinical trial that body weight calculation and dosage of atracurium accordingly has altered duration for recovery from blockade, the results of the study showed that atracurium when used according to ideal body weight as compared to total body weight has reduced duration of action. So atracurium dose should be calculated according to ideal body weight rather than total body weight in obese patients.