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Low doses of rocuronium during remifentanil-propofol-based anesthesia in children: comparison of intubating conditions.
Paediatr Anaesth. 2004 Aug; 14(8):636-41.PA

Abstract

BACKGROUND

In this prospective double-blind study, intubation conditions were compared at 90 s following two different low doses of rocuronium during remifentanil and propofol anesthesia in children undergoing ambulatory procedures.

METHODS

Forty-four children (ASA I-II, aged 3-12 years) undergoing day case ENT surgery were premedicated with midazolam 0.5 mg x kg(-1). Following atropine 10 microg x kg(-1), remifentanil infusion 0.5 microg x kg(-1) x min(-1) was started. After 60 s, anesthesia was induced with propofol 2.5 mg x kg(-1). Immediately after a bolus dose of propofol, the children received rocuronium doses of 0.15 mg x kg(-1) (group I, n = 22) or 0.3 mg x kg(-1) (group II, n = 22) in a randomized manner, after which an infusion of propofol 6 mg x kg(-1) h(-1) was added to the infusion of remifentanil 0.5 microg x kg(-1) min(-1) for maintenance of anesthesia. Intubating conditions were evaluated 90 s after rocuronium administration applying the Copenhagen Scoring System which included components of laryngoscopy, vocal cord movement and reaction to intubation. Hemodynamic values were recorded at predetermined time intervals.

RESULTS

Excellent, good and poor intubation conditions were 18.2, 40.9 and 40.9% in group I and 40.9, 54.5 and 4.5% in group II. Clinically acceptable intubating conditions (excellent and good) were significantly higher in group II (95.5%) than in group I (59.1%) (P = 0.004). Mean values of heart rate and blood pressure did not differ significantly between groups. No children required any intervention for hemodynamic instability and/or muscle rigidity.

CONCLUSIONS

The results suggest that 0.3 mg x kg(-1) of rocuronium may be a better low dose than 0.15 mg x kg(-1) of rocuronium for clinically acceptable intubating conditions in pediatric ambulatory surgery during remifentanil-propofol-based anesthesia at the doses used in the study.

Authors+Show Affiliations

Department of Anaesthesiology, Dokuz Eylül University Hospital, Izmir, Turkey. sermin.oztekin@deu.edu.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15283821

Citation

Oztekin, Sermin, et al. "Low Doses of Rocuronium During Remifentanil-propofol-based Anesthesia in Children: Comparison of Intubating Conditions." Paediatric Anaesthesia, vol. 14, no. 8, 2004, pp. 636-41.
Oztekin S, Hepaguşlar H, Kilercik H, et al. Low doses of rocuronium during remifentanil-propofol-based anesthesia in children: comparison of intubating conditions. Paediatr Anaesth. 2004;14(8):636-41.
Oztekin, S., Hepaguşlar, H., Kilercik, H., Kar, A. A., Boyaci, F., & Elar, Z. (2004). Low doses of rocuronium during remifentanil-propofol-based anesthesia in children: comparison of intubating conditions. Paediatric Anaesthesia, 14(8), 636-41.
Oztekin S, et al. Low Doses of Rocuronium During Remifentanil-propofol-based Anesthesia in Children: Comparison of Intubating Conditions. Paediatr Anaesth. 2004;14(8):636-41. PubMed PMID: 15283821.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low doses of rocuronium during remifentanil-propofol-based anesthesia in children: comparison of intubating conditions. AU - Oztekin,Sermin, AU - Hepaguşlar,Hasan, AU - Kilercik,Hakan, AU - Kar,Aysun Afife, AU - Boyaci,Figen, AU - Elar,Zahide, PY - 2004/7/31/pubmed PY - 2004/12/30/medline PY - 2004/7/31/entrez SP - 636 EP - 41 JF - Paediatric anaesthesia JO - Paediatr Anaesth VL - 14 IS - 8 N2 - BACKGROUND: In this prospective double-blind study, intubation conditions were compared at 90 s following two different low doses of rocuronium during remifentanil and propofol anesthesia in children undergoing ambulatory procedures. METHODS: Forty-four children (ASA I-II, aged 3-12 years) undergoing day case ENT surgery were premedicated with midazolam 0.5 mg x kg(-1). Following atropine 10 microg x kg(-1), remifentanil infusion 0.5 microg x kg(-1) x min(-1) was started. After 60 s, anesthesia was induced with propofol 2.5 mg x kg(-1). Immediately after a bolus dose of propofol, the children received rocuronium doses of 0.15 mg x kg(-1) (group I, n = 22) or 0.3 mg x kg(-1) (group II, n = 22) in a randomized manner, after which an infusion of propofol 6 mg x kg(-1) h(-1) was added to the infusion of remifentanil 0.5 microg x kg(-1) min(-1) for maintenance of anesthesia. Intubating conditions were evaluated 90 s after rocuronium administration applying the Copenhagen Scoring System which included components of laryngoscopy, vocal cord movement and reaction to intubation. Hemodynamic values were recorded at predetermined time intervals. RESULTS: Excellent, good and poor intubation conditions were 18.2, 40.9 and 40.9% in group I and 40.9, 54.5 and 4.5% in group II. Clinically acceptable intubating conditions (excellent and good) were significantly higher in group II (95.5%) than in group I (59.1%) (P = 0.004). Mean values of heart rate and blood pressure did not differ significantly between groups. No children required any intervention for hemodynamic instability and/or muscle rigidity. CONCLUSIONS: The results suggest that 0.3 mg x kg(-1) of rocuronium may be a better low dose than 0.15 mg x kg(-1) of rocuronium for clinically acceptable intubating conditions in pediatric ambulatory surgery during remifentanil-propofol-based anesthesia at the doses used in the study. SN - 1155-5645 UR - https://www.unboundmedicine.com/medline/citation/15283821/Low_doses_of_rocuronium_during_remifentanil_propofol_based_anesthesia_in_children:_comparison_of_intubating_conditions_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1155-5645&date=2004&volume=14&issue=8&spage=636 DB - PRIME DP - Unbound Medicine ER -