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Titolo:
Probability of acceptable intubation conditions with low dose rocuronium during light sevoflurane anaesthesia in children
Autore:
Eikermann, M; Renzing-Kohler, K; Peters, J;
Indirizzi:
Univ Essen Gesamthsch, Abt Anasthesiol & Intens Med, Dept Anaesthesiol & Intens Care, D-45122 Essen, Germany Univ Essen Gesamthsch Essen Germany D-45122 Care, D-45122 Essen, Germany Univ Essen Gesamthsch, Dept Biometr, D-45122 Essen, Germany Univ Essen Gesamthsch Essen Germany D-45122 metr, D-45122 Essen, Germany Univ Essen Gesamthsch, Dept Epidemiol & Stat, D-45122 Essen, Germany Univ Essen Gesamthsch Essen Germany D-45122 Stat, D-45122 Essen, Germany
Titolo Testata:
ACTA ANAESTHESIOLOGICA SCANDINAVICA
fascicolo: 8, volume: 45, anno: 2001,
pagine: 1036 - 1041
SICI:
0001-5172(200109)45:8<1036:POAICW>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRACHEAL INTUBATION; NEUROMUSCULAR BLOCKADE; PEDIATRIC-PATIENTS; ADDUCTOR POLLICIS; ANESTHESIA; MIVACURIUM; VECURONIUM; INDUCTION; HALOTHANE; DURATION;
Keywords:
rocuronium; intubating conditions; pediatric;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Eikermann, M Univ Essen Gesamthsch, Abt Anasthesiol & Intens Med, Dept Anaesthesiol & Intens Care, Hufelandstr 55, D-45122 Essen, Germany Univ Essen Gesamthsch Hufelandstr 55 Essen Germany D-45122 y
Citazione:
M. Eikermann et al., "Probability of acceptable intubation conditions with low dose rocuronium during light sevoflurane anaesthesia in children", ACT ANAE SC, 45(8), 2001, pp. 1036-1041

Abstract

Background: To define the rocuronium doses which would provide 50%, 90%, and 95% probability of 'acceptable' intubation conditions during light sevoflurane anaesthesia, we studied 60 children aged 2-7 years in a prospective,randomised, assessor blinded study. Methods: After mask ventilation with 1 MAC sevoflurane/N2O for 17 +/-1 ((x) over bar +/- SD) min we administered rocuronium (either 0.15, 0.22, 0.3, 0.3, or 1.0 mg . kg(-1)) or placebo, and quantified the evoked force of theadductor pollicis muscle. Intubation conditions were assessed before and 2min after injection of the test drug. Results: Intubation conditions were improved significantly with rocuronium. and scored 'acceptable' in 70%, 90%, and 100% of the children after injection of rocuronium 0.15, 0.22, and 0.3 mg kg-1, respectively. In parallel, twitch tension decreased to 53% (6-100), 26% (11-100), and 11% (0-19) of baseline (median (range)). Recovery of train-of-four ratio to 0.8 was achieved 13 (7-19), 16 (8-28), and 27 (23-44) min after injection of the respective rocuronium doses. Higher rocuronium doses did not further improve intubation conditions but only prolonged time of neuromuscular recovery. Logistic regression analysis revealed that rocuronium 0.11 (CI 0.05-0.16), 0.21 (0.14-0.28), and 0.25 (0.13-0.34) mg . kg(-1) provides a 50%, 90%, and 95% probability of 'acceptable' intubation conditions in children during 1 MAC sevoflurane/N2O anaesthesia, respectively. Furthermore, we calculated that force depression of adductor pollicis muscle to 81% (Cl 72-90), 58% (42-74), and 50% (29-71) of baseline is associated with 50%, 90%, and 95% probability of 'acceptable' intubation conditions. Conclusions: Submaximal depression of muscle force with low dose rocuronium improves intubation conditions in children during light sevoflurane anaesthesia while allowing rapid recovery of neuromuscular function. However, when using low dose rocuronium neuromuscular monitoring may be helpful to detect children with inadequate response to the relaxant so as to avoid an unsuccessful intubation attempt.

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Documento generato il 09/04/20 alle ore 13:29:05