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isoflurane + atracurium is a combination of an inhalational general anesthetic and a non-depolarizing neuromuscular blocking agent (NMBA) used for balanced anesthesia. Isoflurane, a halogenated ether, induces and maintains general anesthesia by modulating various ion channels, including GABA-A and glycine receptors, and inhibiting NMDA receptors. Atracurium besylate is a competitive antagonist at nicotinic acetylcholine receptors at the neuromuscular junction, providing skeletal muscle relaxation required for surgical procedures. This specific combination was evaluated by Ain Shams University in a Phase 4 clinical trial to compare its effects on blood glucose levels in diabetic patients against total intravenous anesthesia (TIVA) during video-assisted thoracoscopy (VATS).
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