In clinical practice, the laryngeal mask airway is an easy-to-use supraglottic airway device. However, the cis-atracurium dosage for laryngeal mask insertion has not been standardised. We aimed to determine the optimal dose of cis-atracurium using a sequential method for successful laryngeal mask insertion. The cohort study protocol is registered at clinicaltrial.gov (NCT-03668262). Twenty-three patients undergoing elective urinary surgery were sequentially administered cis-atracurium doses as follows: 150, 100, 70, 50, 30, and 20 μg·kg− 1. The main outcome involved the determination of the response to laryngeal mask airway insertion: ≥16 points and < 16 points indicated “satisfactory” and “unsatisfactory” responses, respectively. The median effective dose was estimated using the mean of the seven crossovers from “satisfactory” and “unsatisfactory” responses. The primary outcome involved the determination of the median effective dose (ED50) of cis-atracurium for laryngeal mask airway insertion. The median effective dose of cis-atracurium was 26.5 μg·kg− 1 (95% CI 23.6–29.8) using the sequential method. Heart rate was decreased in the 50 μg·kg− 1 group compared to that in the 30 μg·kg− 1 group at timepoints T7, T8, and T10 (P = 0.0482, P = 0.0460, and P = 0.0236, respectively), but no difference was observed in the 20 μg·kg− 1 group. Systolic blood pressure was decreased in the 50 μg·kg− 1 group compared to that in the 20 μg·kg− 1 group at timepoints T2, T3, and T4 (P = 0.0159, P = 0.0233, and P = 0.0428, respectively). The train-of-four value was significantly lower in the 50 μg·kg− 1 group than in the 30 μg·kg− 1 group at timepoint T3 (P = 0.0326). The ED50 of cis-atracurium was 26.5 μg·kg− 1 for laryngeal mask airway insertion. Clinicaltrial.gov Registry, NCT03668262, Registered on 11 September 2018.

中文翻译：

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泌尿外科手术患者全麻期间顺式阿曲库铵插入喉罩气道的中位有效剂量（ED50）。

在临床实践中，喉罩气道是一种易于使用的声门上气道装置。然而，用于喉罩插入的顺式阿曲库铵剂量尚未标准化。我们旨在确定使用成功的喉罩插入的顺序方法的顺式阿曲库铵的最佳剂量。队列研究方案已在Clinicaltrial.gov（NCT-03668262）上注册。23例行择期泌尿外科手术的患者按以下顺序依次服用顺阿曲库铵剂量：150、100、70、50、30和20μg·kg-1。主要结果涉及确定对喉罩插入气道的反应：≥16分和<16分分别表示“满意”和“不满意”。使用来自“满意”和“不满意”响应的七个交叉的平均值来估计中位有效剂量。主要结果涉及确定喉罩插入气道时顺式阿曲库铵的中位有效剂量（ED50）。使用序贯法时，顺式阿曲库铵的中位有效剂量为26.5μg·kg-1（95％CI 23.6–29.8）。在时间点T7，T8和T10，50μg·kg-1组的心率比30μg·kg-1组的心率降低（分别为P = 0.0482，P = 0.0460和P = 0.0236），但在20μg·kg-1组中未观察到差异。在时间点T2，T3和T4，50μg·kg-1组的收缩压比20μg·kg-1组的降低（分别为P = 0.0159，P = 0.0233和P = 0.0428） 。在时间点T3，50μg·kg-1组的四列值明显低于30μg·kg-1组（P = 0.0326）。插入喉罩气道时，顺式阿曲库铵的ED50为26.5μg·kg-1。Clinicaltrial.gov注册表，NCT03668262，于2018年9月11日注册。