Cisatracurium Hameln

Adults: Initial Doses: You can choose one of two intubating doses of Cisatracurium, depending on how soon you need to intubate the trachea and how long the surgery is expected to last. The dose of the neuromuscular blocking agent is not the only thing that matters. Co-induction agents (for example fentanyl and midazolam) and the depth of anesthesia also influence intubation conditions. Doses of 0.15 (3 × ED95) and 0.20 (4 × ED95) mg/kg Cisatracurium, given as part of a propofol/nitrous oxide/oxygen induction-intubation technique, may generally produce GOOD or EXCELLENT intubation conditions in 2.0 and 1.5 minutes, respectively. You can expect similar conditions when these doses are given as part of a thiopental/nitrous oxide/oxygen induction-intubation technique. In two intubation studies that used thiopental or propofol with midazolam and fentanyl as co-induction agents, EXCELLENT conditions were reached most often with the 0.2 mg/kg dose of cisatracurium, compared with the 0.15 mg/kg dose. During propofol anesthesia, the clinically effective duration of action is 55 minutes (range: 44 to 74 minutes) for 0.15 mg/kg and 61 minutes (range: 41 to 81 minutes) for 0.20 mg/kg Cisatracurium. Lower doses may take longer to give satisfactory intubation conditions. Doses up to 8 × ED95 Cisatracurium have been given safely to healthy adult patients and to patients with serious cardiovascular disease. These larger doses last longer in clinically effective action.

Children: Initial Doses: The recommended dose of Cisatracurium for children 2 to 12 years of age is 0.10 to 0.15 mg/kg, given over 5 to 10 seconds during either halothane or opioid anesthesia. During stable opioid/nitrous oxide/oxygen anesthesia, 0.10 mg/kg Cisatracurium produces maximum neuromuscular block in an average of 2.8 minutes (range: 1.8 to 6.7 minutes), and the block stays clinically effective for 28 minutes (range: 21 to 38 minutes). With 0.15 mg/kg under the same stable anesthesia, maximum neuromuscular block comes in about 3.0 minutes (range: 1.5 to 8.0 minutes), and clinically effective block (time to 25% recovery) lasts 36 minutes (range: 29 to 46 minutes).

Infants: Initial Doses: For intubation of infants 1 month to 23 months old, the recommended dose of Cisatracurium is 0.15 mg/kg, given over 5 to 10 seconds during either halothane or opioid anesthesia. During stable opioid/nitrous oxide/oxygen anesthesia, 0.15 mg/kg produces maximum neuromuscular block in about 2.0 minutes (range: 1.3 to 3.4 minutes), and clinically effective block (time to 25% recovery) lasts about 43 minutes (range: 34 to 58 minutes).