Use a nerve stimulator to monitor effect and determine when subsequent doses (about a fifth of the intubating dose) are required.
Higher doses result in shorter onset times but longer duration of action.
- Intermediate-acting neuromuscular blocking agents, e.g.:
- Cisatracurium (shorter-acting)
- Intubation dose 0.1–0.15 mg/kg.
- Onset 3–5 minutes.
- Duration of action 45–55 minutes.
- Eliminated by Hoffman degradation, therefore can be used in renal or liver impairment
- Cisatracurium (shorter-acting)
- Vecuronium
- Intubation dose 0.08–0.1 mg/kg.
- Intubate after 2 minutes.
- Duration 20–30 minutes.
- Eliminated by liver and kidney: avoid in renal and liver impairment.