Equipotent Dose and Cost Comparison of Atracurium and Rocuronium in Propofol-Anaesthetized Pigs

Neuromuscular blocking agents such as atracurium and rocuronium are commonly used during anaesthetic procedures in laboratory pigs; However, species-specific dosing guidelines remain limited, leading to reliance on data extrapolated from other species. This prospective, blinded, randomized, crossover study aimed to determine equipotent dose for atracurium (A) and rocuronium (R) in laboratory pigs (n=12) receiving propofol, and to compare their cost-effectiveness. For both drugs, the infusion rate was adjusted following an up-and-down titration to maintain a Train-of-four count between 3 and 4. Group differences were analyzed using the Wilcoxon signed rank test. The initial induction dose (mg/kg) was comparable between atracurium (2.3 [1.8-2.6]) and rocuronium (2 [2-2]), while atracurium was associated with higher costs (CHF/kg: A, 1.122 [0.878-1.366] versus R, 0.208 [0.208-0.208]; p = 0.002725). The maintenance infusion rate (mg/kg/h) was approximately 40% lower for atracurium (2.7 [2.5-2.8]) than for rocuronium (4.5 [4.4-4.5]; p = 0.004922), yet the maintenance cost (CFH/kg/h) remained higher for atracurium (A: 1.30 [1.22-1.37] versus R: 0.47 [0.45-0.47]; p = 0.0043). This study reports higher doses for anaesthetized pigs compared to other species, and demonstrates that rocuronium offers superior cost-effectiveness compared to atracurium under these experimental conditions.