midazolam + fentanyl + etomidate + cisatracurium besylate

This is a combination of four intravenous drugs—midazolam, fentanyl, etomidate, and cisatracurium besylate—used together primarily for rapid sequence intubation (RSI) or deep sedation in critical care and emergency settings. - **Midazolam** is a short-acting benzodiazepine with sedative, anxiolytic, amnesic, muscle relaxant, and anticonvulsant properties. It acts as a positive allosteric modulator at the GABA-A receptor to enhance inhibitory neurotransmission[1]. - **Fentanyl** is a potent synthetic opioid analgesic that acts primarily as an agonist at the mu-opioid receptor to provide analgesia and sedation[4][5]. - **Etomidate** is an imidazole-derived nonbarbiturate hypnotic agent used for induction of anesthesia; it enhances GABAergic transmission by acting on the GABA-A receptor[3][4][6]. - **Cisatracurium besylate** is a non-depolarizing neuromuscular blocking agent that antagonizes nicotinic acetylcholine receptors at the neuromuscular junction to induce skeletal muscle paralysis (facilitate intubation/mechanical ventilation)[7]. This combination provides rapid onset of unconsciousness (etomidate/midazolam), profound analgesia (fentanyl), amnesia (midazolam), and complete neuromuscular blockade (cisatracurium). It is commonly used in critically ill patients requiring airway management or mechanical ventilation.

Other names

Anesthesia induction regimen (Xi'an Jiaotong University asthma trial)