To compare the neuromuscular blocking effects of cisatracurium during isoflurane versus propofol anesthesia in dogs.
Prospective, randomized study.
A total of 20 healthy, client-owned dogs (16 females, four males) weighing 12.5–22 kg and aged 1–8 years.
Dogs undergoing elective surgery were randomized in equal numbers to an isoflurane (ISO) or propofol (PPF) group. Other drugs used during anesthesia were equal between groups. Single-twitch (ST) stimulation was used to monitor neuromuscular response. After recording the baseline ST (T0), cumulative doses of cisatracurium (0.05 mg kg–1) were administered intravenously until ST/T0 ≤5%. Effective doses 50 (ED50) and 95 (ED95) of cisatracurium in each group were calculated from group dose-response curves. Recovery of ST (TR) was defined as spontaneous recovery of ST to 80–120% of T0 remaining stable for 2 minutes. The ST after each dose of cisatracurium, duration 25% (time after the last dose until 25% recovery of TR), recovery index (time to recovery from 25% to 75% of TR) and duration to TR (time after the last dose until recovery of TR) were recorded.
Incremental doses of cisatracurium, median (range), were 2 (1–3) in ISO and 4 (2–5) in PPF to achieve ≥95% depression of ST/T0 (p < 0.01). ED50 and ED95 were 20 μg kg–1 and 117 μg kg–1 in ISO and 128 μg kg–1 and 167 μg kg–1 in PPF, respectively. The duration 25%, recovery index and duration to TR, median (range), were longer in ISO [22.6 (10.3–24.3), 5.3 (3.0–7.8) and 36.1 (20.1–49.7) minutes, respectively] than in PPF [10.2 (6.8–16.5), 3.0 (2.0–3.8) and 17.7 (14.2–28.7) minutes, respectively] (p < 0.01).
Conclusions and clinical relevance
Cisatracurium-induced neuromuscular blockade was significantly enhanced and prolonged by isoflurane compared with propofol.
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- The use of the nondepolarizing neuromuscular blocking drug cis-atracurium in dogs.Vet Anaesth Analg. 2001; 28: 156-160
- cis-Atracurium in dogs with and without porto-systemic shunts.Vet Anaesth Analg. 2006; 33: 17-23
- Comparative study of neuromuscular blocking and hemodynamic effects of rocuronium and cisatracurium under sevoflurane or total intravenous anesthesia.Middle East J Anaesthesiol. 2009; 20: 39-51
- Variability of duration of action of neuromuscular-blocking drugs in elderly patients.Acta Anaesthesiol Scand. 2005; 49: 312-315
- Studies on the pharmacokinetics of cisatracurium in anesthetized dogs: in vitro-in vivo correlations.J Vet Pharmacol Ther. 2009; 32: 571-576
- The undesirable effects of neuromuscular blocking drugs.Anaesthesia. 2009; 64: 10-21
- Human dose–response curves for neuromuscular blocking drugs: a comparison of two methods of construction and analysis.Anesthesiology. 1980; 53: 161-166
- Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: the Stockholm revision.Acta Anaesthesiol Scand. 2007; 51: 789-808
- Nimbex (cisatracurium besylate) injection label.GlaxoSmithKline Manufacturing SpA, Italy2010
- Recovery from neuromuscular blockade after either bolus and prolonged infusions of cisatracurium or rocuronium using either isoflurane or propofol-based anesthetics.Anesth Analg. 2000; 91: 1250-1255
- Xylazine premedication does not modify the onset and duration of cisatracurium blockade in anaesthetized dogs.J Vet Med A Physiol Pathol Clin Med. 2007; 54: 254-256
- Neuromuscular blocking properties of atracurium during sevoflurane or propofol anaesthesia in dogs.Vet Anaesth Analg. 2005; 32: 222-227
- The cardiovascular effects and histamine-releasing properties of 51W89 in patients receiving nitrous oxide/opioid/barbiturate anesthesia.Anesthesiology. 1995; 82: 1131-1138
- Neuromuscular effects of cisatracurium in anesthetized dogs.Vet Anaesth Analg. 2000; 27: 101-102
- The effects of propofol, isoflurane and sevoflurane on vecuronium infusion rates for surgical muscle relaxation in dogs.Vet Anaesth Analg. 2006; 33: 169-174
- Differences between acceleromyography and electromyography during neuromuscular function monitoring in anesthetized Beagle dogs.Vet Anaesth Analg. 2015; 42: 233-241
- Newer neuromuscular blocking agents: how do they compare with established agents?.Drugs. 2001; 61: 919-942
- Pharmacokinetics and pharmacodynamics of cisatracurium after a short infusion in patients under propofol anesthesia.Anesth Analg. 1998; 87: 1158-1163
- Comparative pharmacology of cisatracurium (51W89), atracurium, and five isomers in cats.Anesthesiology. 1996; 85: 169-177
- Histamine release and atracurium.Br J Anaesth. 1986; 58: 19S-22S
- Augmentation of the neuromuscular blocking effects of cisatracurium during desflurane, sevoflurane, isoflurane or total i.v. anaesthesia.Br J Anaesth. 1998; 80: 308-312
Published online: March 29, 2020
Accepted: March 9, 2020
Received: April 28, 2019
© 2020 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.