Nimbex for intubation

Q: Cisatracurium (Nimbex) at the higher dose provides an advantage during intubation?

A) True

B) False

Answer: A

Although cisatracurium is not usually recommended as a neuro-muscular agent for rapid sequence intubation (RSI) but can be used. The commonly used cisatracurium (Nimbex) dose during intubation is 0.15 mg/kg, but the recommended dose is 0.2 mg/kg. It provides the advantage of about 30 seconds in obtaining good conditions for intubation. 

When administered during the induction of adequate anesthesia, a good to excellent condition for tracheal intubation occurred in 2.0 minutes following 0.15 mg/kg dose of cisatracurium and in 1.5 minutes following 0.2 mg/kg of cisatracurium.

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References:

1. Lee H, Jeong S, Choi C, Jeong H, Lee S, Jeong S. Anesthesiologist's satisfaction using between cisatracurium and rocuronium for the intubation in the anesthesia induced by remifentanil and propofol. Korean J Anesthesiol. 2013 Jan;64(1):34-9. doi: 10.4097/kjae.2013.64.1.34. Epub 2013 Jan 21. PMID: 23372884; PMCID: PMC3558647.

2. Bluestein LS, Stinson LW Jr, Lennon RL, Quessy SN, Wilson RM. Evaluation of cisatracurium, a new neuromuscular blocking agent, for tracheal intubation. Can J Anaesth. 1996 Sep;43(9):925-31. doi: 10.1007/BF03011806. PMID: 8874910.