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A combination of two non-depolarizing neuromuscular blocking agents used in anesthesia as an adjunct to general anesthesia to facilitate endotracheal intubation and provide skeletal muscle relaxation during surgery or mechanical ventilation. The combination demonstrates synergistic (supra-additive) effects, with studies showing a longer duration of neuromuscular blockade than would be expected from simple additivity of the individual drugs. It has been investigated for facilitating endotracheal intubation, particularly when succinylcholine is contraindicated. Half-dose combinations have been shown to provide excellent intubating conditions. While onset time findings vary, the combination generally results in a longer duration of action compared to either drug alone. The synergistic effect allows for reduced dosages of each drug while maintaining efficacy. Hemodynamic stability appears similar to vecuronium alone.
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