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However, the\n                      <jats:italic>cis-<\/jats:italic>\n                      atracurium dosage for laryngeal mask insertion has not been standardised. We aimed to determine the optimal dose of\n                      <jats:italic>cis-<\/jats:italic>\n                      atracurium using a sequential method for successful laryngeal mask insertion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The cohort study protocol is registered at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrial.gov\">clinicaltrial.gov<\/jats:ext-link>\n                      (NCT-03668262). Twenty-three patients undergoing elective urinary surgery were sequentially administered\n                      <jats:italic>cis-<\/jats:italic>\n                      atracurium doses as follows: 150, 100, 70, 50, 30, and 20\u2009\u03bcg\u00b7kg\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      . The main outcome involved the determination of the response to laryngeal mask airway insertion: \u226516 points and\u2009&lt;\u200916 points indicated \u201csatisfactory\u201d and \u201cunsatisfactory\u201d responses, respectively. The median effective dose was estimated using the mean of the seven crossovers from \u201csatisfactory\u201d and \u201cunsatisfactory\u201d responses. The primary outcome involved the determination of the median effective dose (ED50) of\n                      <jats:italic>cis-<\/jats:italic>\n                      atracurium for laryngeal mask airway insertion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median effective dose of\n                      <jats:italic>cis-<\/jats:italic>\n                      atracurium was 26.5\u2009\u03bcg\u00b7kg\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      (95% CI 23.6\u201329.8) using the sequential method. Heart rate was decreased in the 50\u2009\u03bcg\u00b7kg\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      group compared to that in the 30\u2009\u03bcg\u00b7kg\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      group at timepoints T7, T8, and T10 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u20090.0482,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u20090.0460, and\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u20090.0236, respectively), but no difference was observed in the 20\u2009\u03bcg\u00b7kg\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      group. Systolic blood pressure was decreased in the 50\u2009\u03bcg\u00b7kg\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      group compared to that in the 20\u2009\u03bcg\u00b7kg\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      group at timepoints T2, T3, and T4 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u20090.0159,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u20090.0233, and\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u20090.0428, respectively). The train-of-four value was significantly lower in the 50\u2009\u03bcg\u00b7kg\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      group than in the 30\u2009\u03bcg\u00b7kg\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      group at timepoint T3 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u20090.0326).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The ED50 of\n                      <jats:italic>cis-<\/jats:italic>\n                      atracurium was 26.5\u2009\u03bcg\u00b7kg\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      for laryngeal mask airway insertion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrial.gov\">Clinicaltrial.gov<\/jats:ext-link>\n                      Registry,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">NCT03668262<\/jats:ext-link>\n                      , Registered on 11 September 2018.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12871-020-00982-3","type":"journal-article","created":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T05:02:46Z","timestamp":1584594166000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The median effective dose (ED50) of cis-Atracurium for laryngeal mask airway insertion during general Anaesthesia for patients undergoing urinary surgery"],"prefix":"10.1186","volume":"20","author":[{"given":"Xiaohua","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxu","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jixiu","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianlong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,19]]},"reference":[{"issue":"5","key":"982_CR1","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1007\/s10877-019-00315-x","volume":"33","author":"Davide Cattano","year":"2019","unstructured":"Cattano D, Van Zundert TCRV, Wojtczak J. 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