Inﬂuence of Hypnotics on Cisatracurium-induced Neuromuscular Block. Use of Acceleromyograhpy

Braga, Angélica de Fátima de Assunção; Braga, Franklin Sarmento da Silva; Potério, Glória Maria Braga; Frias, José Aristeu Fachini; Pedro, Fernanda Maria Silva; Munhoz, Derli Conceição

doi:10.1016/j.bjane.2012.05.005

Cited by 3 publications

(7 citation statements)

References 25 publications

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“…In addition to the dose of cis-atracurium, the onset time of the NMB can be influenced by other drugs that affect muscle contractility and/or cardiac output, such as benzodiazepines,19 acepromazine,20 alpha-2 adrenoceptor agonist drugs,15 20 propofol,21–23 inhalant agents23 and lidocaine 24. In previous studies, the NMB onset after cis-atracurium was longer in dogs administered acepromazine (2.5±0.6 minutes and 6.2±1.4 minutes),1 20 dexmedetomidine (3.8 (2.6–5) minutes)4 and acepromazine plus xylazine (3.2±1.4 minutes)20 compared with the present study.…”

Section: Discussionmentioning

confidence: 97%

“…Another hypothesis that cannot be discarded is that the faster onset time of the NMB was the result of a direct interaction between cis-atracurium and fentanyl and lidocaine. Lidocaine was described to increase the sensitivity to cis-atracurium on rats in vitro 21 and in vivo 30. This effect was associated with interactions of local anaesthetics with presynaptic and postsynaptic nicotinic receptors in the neuromuscular junction, which would affect ion transport and produce a muscle membrane stabilisation effect 10 21 31 32.…”

Section: Discussionmentioning

confidence: 99%

“…Lidocaine was described to increase the sensitivity to cis-atracurium on rats in vitro 21 and in vivo 30. This effect was associated with interactions of local anaesthetics with presynaptic and postsynaptic nicotinic receptors in the neuromuscular junction, which would affect ion transport and produce a muscle membrane stabilisation effect 10 21 31 32. Such mechanism would result on a decrease in the onset7 24 and an increase in the duration and potency of NMB drugs 8 9 33.…”

Section: Discussionmentioning

confidence: 99%

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Onset and duration of cis‐atracurium neuromuscular block during fentanyl and lidocaine infusions in isoflurane‐anaesthetised dogs

Ida¹,

Van-Wijnsberghe²,

Tutunaru³

et al. 2020

Veterinary Record

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BackgroundThis retrospective study assessed the onset and duration of the neuromuscular block (NMB) induced by cis-atracurium 0.15 mg/kg intravenously with and without fentanyl or lidocaine infusions in 45 isoflurane-anaesthetised dogs.MethodsDogs with neuromuscular function assessed by a calibrated train-of-four (TOF) monitor with stimulation (every 13 s) of the peroneal nerve were included. The onset and duration of the NMB were defined as the time from cis-atracurium administration until TOF=0 and the time during TOF=0 display, respectively.ResultsThe NMB onset was shorter during fentanyl (mean±sd) (1.9±0.7 minutes; P=0.0042) and lidocaine (2.0±0.7 minutes; P=0.0154) compared with control (2.9±0.8 minutes). The NMB duration was shorter in the fentanyl (27.5±7.3 minutes; P=0.0491), but not in the lidocaine group (32.3±6.9 minutes; P=0.0790), compared with control (33.7±9.1 minutes). The NMB onset was poorly but significantly correlated with the dose of fentanyl and lidocaine administered before cis-atracurium (r=−0.3396; P=0.0225). The fentanyl and lidocaine groups received more crystalloid and colloid boluses than the control.ConclusionsFentanyl and lidocaine shortened the NMB onset and the former decreased the NMB duration. Further prospective studies are required to clarify whether this was associated with an indirect decrease in blood pressure or a direct interaction between cis-atracurium and fentanyl and lidocaine.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Onset and duration of cis‐atracurium neuromuscular block during fentanyl and lidocaine infusions in isoflurane‐anaesthetised dogs

Ida¹,

Van-Wijnsberghe²,

Tutunaru³

et al. 2020

Veterinary Record

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“…5 Data from the latter study indicated that the onset time of the NMB induced by cis-atracurium can be shortened in isoflurane-anaesthetised dogs administered fentanyl and lidocaine. 5 It can also be influenced by others drugs that affect muscle contractility and/or cardiac output, such as benzodiazepines, 6 acepromazine, 7 alpha-2 adrenoceptor agonist drugs, 7,8 propofol 9,10 and inhalant agents. 10,11 To date, there has been no study in cats comparing cisatracurium and different anaesthetic protocols.…”

Section: Discussionmentioning

confidence: 99%

Neuromuscular blockade effects of cisatracurium in 11 cats undergoing ophthalmological surgery anaesthetised with isoflurane

Wijnsberghe¹,

Ida

Dmitrović³

et al. 2021

Journal of Feline Medicine and Surgery

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Case series summary This case series describes the neuromuscular blockade (NMB) following 0.15 mg/kg intravenous (IV) cisatracurium administration in 11 cats undergoing ophthalmological surgery and anaesthetised with isoflurane. Anaesthetic records were analysed retrospectively. Neuromuscular function was assessed by a calibrated train-of-four (TOF) monitor. Cats were 73 ± 53 months old, weighed 4 ± 1 kg and were of American Society of Anesthesiologists’ physical classification 2. Duration of anaesthesia and surgery were 144 ± 27 and 94 ± 24 mins, respectively. The lowest TOF count was zero in four cats, four in six cats and for one cat the TOF ratio never decreased below 31%. The time of onset was between 1 and 6 mins after the administration of cisatracurium and the mean duration of action was 20.4 ± 10.1 mins. Relevance and novel information Cisatracurium at a dose of 0.15 mg/kg IV did not consistently induce a TOF count of zero in all cats. The dose used in these cats did not produce any remarkable cardiovascular side effects. Although the NMB was not complete, the dose given was sufficient to produce central eyeball position, which was the goal of the ophthalmic surgeries.

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“…Authors showed that NMB-induced neuromuscular blockade is potentiated and prolonged when halogenated anesthetics are used; in addition, inhalational anesthetics increase the neuromuscular blockade produced by nondepolarizing drugs in a dose-dependent manner [ 6 , 7 , 8 ]. Neuromuscular blocking agents cause myorelaxation but do not have hypnotic and analgesic effects, so they should always be administered with anesthetic and analgesic drugs [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Cisatracurium in Sevoflurane and Propofol Requirements in Dog-Undergoing-Mastectomy Surgery

Interlandi

Pietro

Costa

et al. 2022

Animals

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The purpose of the present study was to test whether the addition of cisatracurium in combination with propofol and sevoflurane would result in a change in doses of used anesthetic drugs. Ten dogs (Group A) undergoing elective unilateral mastectomy surgery were included in the study. To induce and maintain anesthesia, subjects received propofol and sevoflurane at varying doses; analgesia was performed with remifentanil. After three months, the same subjects (Group B) underwent contralateral mastectomy and received the same anesthetic protocol with the addition of cisatracurium at a dosage of 0.2 mg/kg−1. The following parameters were monitored during anesthesia: heart rate, systolic blood pressure, end-tidal CO2, oxygen saturation, halogenate requirement, and rectal temperature at baseline (T0), induction (T1), 5 (T5), 10 (T10), 15 (T15), 20 (T20), 25 (T25), 30 (T30), and 35 (T35) time points. In Group A, halogenate requirement was reduced at all the time points other than T1 (p < 0.001); in Group B, the percentage of halogenate requirement was already reduced at T1 and remained constant during the experimental period, showing no significant intragroup differences. The dose requirements of sevoflurane and propofol varied significantly between the two groups, with significantly lower dosages in the Group B (the cisatracurium-treated group). Moreover, patients treated with cisatracurium showed a stable anesthetic plan. The nondepolarizing-muscle-relaxant cisatracurium besylate could be considered a useful adjunct to anesthetic protocols.

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Inﬂuence of Hypnotics on Cisatracurium-induced Neuromuscular Block. Use of Acceleromyograhpy

Cited by 3 publications

References 25 publications

Onset and duration of cis‐atracurium neuromuscular block during fentanyl and lidocaine infusions in isoflurane‐anaesthetised dogs

Onset and duration of cis‐atracurium neuromuscular block during fentanyl and lidocaine infusions in isoflurane‐anaesthetised dogs

Neuromuscular blockade effects of cisatracurium in 11 cats undergoing ophthalmological surgery anaesthetised with isoflurane

Effects of Cisatracurium in Sevoflurane and Propofol Requirements in Dog-Undergoing-Mastectomy Surgery

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