Comparison of the effect of Atracurium and Cis-Atracurium injection on hemodynamic status and Neutrophil-to-Lymphocyte Ratio (NLR) during anesthesia induction

Comparison of hemodynamic changes and Neutrophil to Lymphocyte Ratio changes caused by Atracurium and Ais-Atracurium injection.

A clinical trial with parallel groups, double-blind, randomized, phase 2 on 80 patients. randomization will be done using a coin toss.

This is a randomized double-blind clinical trial that will be conducted on 80 patients in Al-Zahra Hospital, Isfahan. After the approval of the ethics committee of the university and obtaining the consent of the patients, the patients are randomly assigned into groups, the desired intervention is applied in each group, and the blood samples and clinical symptoms of the patient are examined and recorded. The researcher who records the patient's symptoms, laboratory experts, the analyzers, as well as the patients won't know the type of intervention applied in each group and therefore they are all blind.

Inclusion criteria: age 18 to 65 years, class I and II ASA anesthesia, informed consent, and candidate for general anesthesia with Atracurium and Cis-Atracurium Non-Inclusion criteria: history of heart disease and hemodynamic disorders, drug addiction, use of psychedelics, antihistamines, and corticosteroids in the last week, obesity, diabetes, pregnancy, and breastfeeding.

Intervention group A: In this group of patients, after preparation and connection of monitoring, Sodium Thiopental 5 mg/kg as an anesthetic, Fentanyl 100 micrograms as an analgesic, and also for muscle relaxation 0.5 mg/kg Atracurium within 60 seconds. Intervention group B: In this group of patients, after preparation and connection of monitoring, Sodium Thiopental 5 mg/kg as an anesthetic, Fentanyl 100 micrograms as an analgesic, and also for muscle relaxation 0.15 mg/kg Cis-Atracurium within 60 seconds.

Heart Rate, Blood Pressure, Spo2, NLR

This is a simple randomized clinical trial that patients are divided into groups based on flipping a coin; After the first flip of the coin, for the first patient, atracurium is selected for injection in the case of heads, and in the case of tails, cis atracurium is selected. Then, from the second patient onwards, individuals enter the groups one by one until the number reaches 40 people in each group.

This is a double-blind clinical trial so that, before obtaining consent, the patients will be informed of the study but will not be informed about the type of intervention received. Also, the researchers responsible for collecting and analyzing the data won't be informed about the intervention group; therefore, they are all blind.