Background: Cisatracurium besylate in clinical practice is devoid of histamine-induced cardiovascular effects and atracurium besylate can cause hypotension in humans, We compared the influence of two muscle relaxants, cisatracurium besylate and atracurium besylate, of the hemodynamic effects and efficacy parameters.

Aim: To evaluate the safety and efficacy of Cisatracurium besylate versus Atracurium besylate as non depolarising muscle relaxants in patients undergoing diagnostic or therapeutic surgical procedures.

Methodology: 100 ASA grade 1/3 patients aged between 18 to 65 years undergoing diagnostic and therapeutic surgical procedures were selected and devided into two groups of 50 each.Group A received 0.5mg/kg intravenous bolus dose and 0.1 mg/kg of maintainance dose of Atracurium besylate and Group C received 0.2mg/kg intravenous bolus dose and 0.03 mg/kg dose of Cisatracurium besylate till the end of surgery. Anesthesia was induced with propofol 2mg/kg IV plus fentanyl 2 mcg/kg and maintained with N2O/O2/halothane . The electromyographic response of the adductor pollicis was recorded. Train-of-four stimulation was given every 20 seconds.

Results: There were significant difference in between mean onset time and mean clinical duration in two groups.Atracurium besylate has less mean onset time and mean clinical duration 3.24 min and 25 min,Mean recovery time after reversal is more in Atracurium besylate group 6 min than Cisatracurium besylate group 4.76 min,Mean recovery index is more in Cisatracurium besylate group 4.2 min than Atracurium besylate group 3,72 min.MAP is significantly decreased in Group A post intubation and after bolus dose of relaxant.

Conclusion: To summarize, in our study, intravenous Cisatracurium besylate is an attractive intermediate acting neuromuscular blocking agent that provide cardiovascular stability and without apparent histamine release and it prolongs the mean clinical duration and reduces the mean receovery time after giving reversal agents.cisatracurium besylate can be better choice for surgical procedures of 60-120 minutes.