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Cisatracurium

Non-depolarizing neuromuscular blocker

CCP: Adjunct to general anesthesia to facilitate intubation

CCP: Skeletal muscle relaxation during mechanical ventilation

Cautions

CCP: All indications

Initial 0.15-0.2 mg/kg IV bolus
Maintenance 3mcg/kg/min then reduce to 1-2 mcg/kg/min to maintain neuromuscular blockade.

CCP: All indications

1-23 months
- Initial dose: 0.15 mg/kg IV bolus
- Maintenance: 3mcg/kg/min then reduce to 1-2 mcg/kg/min to maintain neuromuscular blockade.
2-12 years
- Initial dose: 0.1-0.15 mg/kg IV bolus
- Maintenance: 3mcg/kg/min then reduce to 1-2 mcg/kg/min to maintain neuromuscular blockade.

Binds to motor end-plate cholinergic receptors. This antagonises acetylcholine activity that results in neuromuscular blockade.

Onset: 2-3 minutes

Half-life: 22-29 minutes

Peak plasma time 3-5 minutes

Duration: 55-65 minutes

Patients with burns have been known to develop resistance to neuromuscular blockade.
Consider extending the interval between initial bolus and the 45 minute start of the maintenance infusion in end stage renal disease.
Use a peripheral nerve stimulator to determine adequate muscle relaxation. As an alternative to a peripheral nerve stimulator an EEG may be utilized.
Not recommended for rapid sequence intubation due to the timeline for onset.
A larger volume of distribution and plasma concentration has been reported in end-stage liver disease.