Duration of neuromuscular block is more variable and recovery time is shorter with rocuronium than cisatracurium in anesthetized dogs

Objective To compare the variability in the duration of action of a single dose of rocuronium or cisatracurium, and duration of subsequent top‐up doses in anesthetized dogs. Animals Thirty dogs requiring ophthalmic surgery with neuromuscular block. Procedures Neuromuscular function was monitored with train‐of‐four (TOF) and acceleromyography. Dogs received an initial dose of rocuronium 0.6 mg/kg, or cisatracurium 0.15 mg/kg IV, which produced complete neuromuscular block. Upon return of the first response (T1) of TOF, a third of the initial dose was repeated. The duration of the initial dose and its variability were compared between agents. Duration of subsequent top‐up doses was assessed with mixed effect models. Spontaneous (from last return of T1) or neostigmine‐enhanced (from administration to complete recovery) recovery times were measured for each agent. Results Duration of action of the initial dose was [median (range)] 25 (10–60) min with rocuronium and 35 (15–45) min with cisatracurium (p = .231). The variability of rocuronium was 3.25 times larger than cisatracurium (p = .034). Duration of top‐up doses did not vary for either agent. Spontaneous recovery was shorter for rocuronium [15 (10–20) min] than cisatracurium [25 (15–45) min] (p = .02). Neostigmine‐enhanced recovery times were 5 (5–25) for rocuronium and 10 (5–10) for cisatracurium (p = .491). Conclusions Duration of action for a single dose is significantly more variable with rocuronium than cisatracurium. Time to spontaneous recovery was longer for cisatracurium, and cases of unexpectedly long recovery times were observed with both agents. Objective monitoring is recommended.