Pharmacology of Cisatracurium Besylate

Background: In routine anesthesia practice, a variety of neuromuscular blocking agents are used. Cisatracurium besylate is a nondepolarizing neuromuscular blocking agent with an intermediate duration of action. Because of the high molecular weight and polarity, the volume of distribution is small. Cisatracurium besylate undergoes Hofmann elimination, making it an excellent choice for patients suffering from organ failure. Methodology: This review article was prepared after a thorough study of the literature using data search engines such as Scopus, Pubmed, Web of Science, and Google Scholar. This article referred to prior Cisatracurium observational studies and case reports. Review Findings: After learning pharmacology, uses, contraindications of Cisatracurium and reviewing the previous observational studies and case reports about Cisatracurium, this drug is used as a muscle relaxant during general anesthesia for tracheal intubation. It has been used successfully in critical care settings where patients were placed on mechanical ventilation and required complete skeletal muscle paralysis. Systemic or cutaneous release of histamine is not caused by cisatracurium. Conclusion: Cisatracurium is a relatively new intermediate-onset, long-lasting skeletal muscle relaxant. This medication can be used safely in patients with hepatorenal impairment. It, like other muscle relaxants, can be used during elective surgical repair under general anaesthesia as well as in patients undergoing prolonged controlled mechanical ventilation. The only concern could be the cost effectiveness in comparison to other skeletal muscle relaxants on the market.