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Use of cis-atracurium to maintain moderate neuromuscular blockade in experimental pigs

Tutunaru, Alexandru, Dupont, Julien, Huberty, Vincent, Ibrahim, Mostafa, Serteyn, Didier, Sandersen, Charlotte
Veterinary anaesthesia and analgesia 2017 v.44 no.4 pp. 910-914
anesthesia, body weight, females, intravenous injection, isoflurane, ketamine, males, oxygen, researchers, swine
To determine the dose of cis-atracurium needed to produce a moderate neuromuscular blockade (NMB) in pigs.Prospective experimental study.Seven pigs [five females and two males; median (range) body weight: 47 (36–64) kg].Pigs were premedicated with intramuscular midazolam (0.3 mg kg−1) and ketamine (7 mg kg−1). Anaesthesia was induced with intravenous (IV) propofol 3 (1–4) mg kg−1 and maintained with isoflurane in oxygen. Based on a preliminary study, the subjects were administered 0.3 mg kg−1 cis-atracurium followed by 0.48 mg kg−1 hour−1 constant rate infusion (CRI) IV. A moderate NMB was defined as a train-of-four (TOF) count of ≤2 by acceleromyography. When the TOF count was >2, 0.1 mg kg−1 cis-atracurium was administered and the CRI was increased. The cis-atracurium CRI was decreased when the TOF count was under 2 for more than 15 minutes. The total dose of cis-atracurium required to maintain a moderate NMB was calculated as the total amount of cis-atracurium used (both CRI and supplementary boluses) divided by the administration time.The cis-atracurium CRI lasted for 87 (76–151) minutes. To induce and maintain a moderate neuromuscular blockade, the initial dose of cis-atracurium was 0.3 (0.3– 0.5) mg kg−1 and the CRI was 0.71 (0.37–0.98) mg kg−1 hour−1.The doses described in our study may help researchers obtain a moderate NMB using cis-atracurium in pigs.