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

Abstract

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.

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

“…1 For comparison, dogs receiving the same dose (0.15 mg/kg), had an onset time of 2.9 ± 0.8 mins. 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.…”

“…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.…”

“…11 For the same dose of cisatracurium (0.15 mg/kg), dogs had a similar duration of action (34 ± 9 mins) to the present case series, with a significant difference seen for the fentanyl group (28 ± 7 mins). 5…”

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

“…If needed, blockages that showed a duration longer than reported for the canine species [ 5 ] could be antagonized with IV atropine 0.04 mg kg −1 (Atropine Solfato 1 mg mL −1 ATI, Italy) injected 1 min before 0.1 mg kg −1 neostigmine (Prostigmina ® 0.5 mg mL −1 MEDA Farma SpA, Milano, Italy). Potential side effects were appropriately treated.…”

“…In canine practice, neuromuscular-blocking agents (NMBs) have been used in different procedures: ophthalmological procedures (to prevent extraocular muscle contraction and produce a relaxed globe in a central position and reduce the risk of vitreous expansion), thoracotomy, laparotomy, ovariohysterectomy, castrations, diaphragmatic-hernia repair, portosystemic shunts, etc. [ 3 , 4 , 5 ]. 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 ].…”