Comparison of the neuromuscular blocking effects of cisatracurium during isoflurane or propofol anesthesia in dogs

I-Ying Chen; Yun-Yu Liang; Kuan-Sheng Chen; Wei-Ming Lee; Hsien-Chi Wang

doi:10.1016/j.vaa.2020.03.002

Comparison of the neuromuscular blocking effects of cisatracurium during isoflurane or propofol anesthesia in dogs

Vet Anaesth Analg. 2020 Jul;47(4):454-462. doi: 10.1016/j.vaa.2020.03.002. Epub 2020 Mar 29.

Authors

I-Ying Chen¹, Yun-Yu Liang², Kuan-Sheng Chen³, Wei-Ming Lee³, Hsien-Chi Wang⁴

Affiliations

¹ Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan.
² Veterinary Medicine Teaching Hospital, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan.
³ Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan; Veterinary Medicine Teaching Hospital, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan.
⁴ Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan; Veterinary Medicine Teaching Hospital, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan. Electronic address: hcwang@dragon.nchu.edu.tw.

PMID: 32409258
DOI: 10.1016/j.vaa.2020.03.002

Abstract

Objective: To compare the neuromuscular blocking effects of cisatracurium during isoflurane versus propofol anesthesia in dogs.

Study design: Prospective, randomized study.

Animals: A total of 20 healthy, client-owned dogs (16 females, four males) weighing 12.5-22 kg and aged 1-8 years.

Methods: 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.

Results: 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.

Keywords: anesthetic agents; cisatracurium; neuromuscular blockade; small animal anesthesiology; small animal pharmacology.

Publication types

Comparative Study
Randomized Controlled Trial, Veterinary

MeSH terms

Anesthesia / veterinary
Anesthetics, Intravenous*
Animals
Atracurium / analogs & derivatives*
Atracurium / pharmacology
Dogs / surgery*
Drug Interactions
Female
Isoflurane*
Male
Neuromuscular Blockade / veterinary
Neuromuscular Blocking Agents / pharmacology*
Propofol*
Prospective Studies

Substances

Anesthetics, Intravenous
Neuromuscular Blocking Agents
Atracurium
Isoflurane
cisatracurium
Propofol