Is overestimation of bispectral index in sedated intensive care unit patients only related to electromyographic activity?

NMB are reported to potentiate the effects of anesthetics. Despite the emphasis that all NMB are completely devoid of analgesic properties, some elicit analgesia. Laudanosine, the atracurium and cisatracurium metabolite, elicits dose-dependent analgesia. in the mouse, attenuated by coadministration of mu1- and mu2-selective antagonists, indicating a mu-related mechanism for analgesic properties of laudanosine.These data indicate that the coadministration of the NMB atracurium or cisatracurium in sedated patients could potentiate the effects of midazolam and sufentanil sedation, and therefore decrease BIS value.