Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Pharmacodynamic interactions between cisatracurium and rocuronium.

Dara S Breslin1, Kuiran Jiao, Ashraf S Habib

  • 1Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.

Anesthesia and Analgesia
|December 25, 2003
PubMed
Summary

Combining neuromuscular blocking drugs like cisatracurium after rocuronium prolongs cisatracurium

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Inadequate spinal anesthesia for postpartum tubal ligation: a single-center retrospective analysis (2003-2025).

International journal of obstetric anesthesia·2026
Same author

Incidence of and risk factors for new pain diagnoses after cesarean delivery: a retrospective cohort study using the Premier Healthcare Database (2016-2020).

International journal of obstetric anesthesia·2026
Same author

Indications for intensive care unit transfer during delivery hospitalizations: a retrospective cohort study using the premier database (2015-2020).

International journal of obstetric anesthesia·2026
Same author

Antepartum mental health disorders and hypertensive disorders of pregnancy: a retrospective cohort study using the premier healthcare administrative database (2016-2020).

International journal of obstetric anesthesia·2026
Same author

Cesarean Anesthesia Type and Neonatal Outcomes: Comment.

Anesthesiology·2026
Same author

Severe maternal morbidity following Cesarean hysterectomy for placenta accreta spectrum: a historical cohort study.

Canadian journal of anaesthesia = Journal canadien d'anesthesie·2026

Area of Science:

  • Anesthesiology
  • Pharmacology
  • Critical Care Medicine

Background:

  • The sequence of neuromuscular blocking drug administration can influence drug efficacy.
  • Steroidal (e.g., rocuronium) and benzo-isoquinolinium (e.g., cisatracurium) compounds represent distinct classes of neuromuscular blockers.
  • Understanding drug interactions is crucial for optimizing anesthetic management.

Purpose of the Study:

  • To evaluate the impact of prior rocuronium administration on the duration of cisatracurium maintenance doses.
  • To investigate potential synergistic effects between steroidal and benzo-isoquinolinium neuromuscular blocking agents.

Main Methods:

  • Sixty adult patients received isoflurane, nitrous oxide, and oxygen anesthesia.
  • Patients were randomized into three groups receiving different sequences and types of neuromuscular blocking drugs.

Related Experiment Videos

  • Neuromuscular blockade was monitored using acceleromyography (TOF-Guard) to assess the clinical duration of drug effects.

    • Main Results:

    • The clinical duration of cisatracurium maintenance doses was significantly prolonged when administered after an initial dose of rocuronium (Group I vs. Groups II and III).
    • Group I (rocuronium followed by cisatracurium) showed longer durations compared to cisatracurium followed by cisatracurium or rocuronium followed by rocuronium.
    • Statistical significance was observed at P < 0.05, P < 0.01, and P < 0.001 levels for different comparisons.

    Conclusions:

    • Administering cisatracurium maintenance doses after an intubating dose of rocuronium significantly prolongs cisatracurium's clinical effect.
    • This finding supports the hypothesis that combining structurally dissimilar neuromuscular blocking drugs can lead to synergistic interactions.
    • Anesthetic protocols should consider potential synergistic effects when using sequential administration of different neuromuscular blocking agents.