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Tracheal intubating conditions and pharmacodynamics following cisatracurium in infants and children undergoing halothane and thiopental-fentanyl anesthesia.
Paediatr Anaesth. 2007 Feb; 17(2):113-20.PA

Abstract

BACKGROUND

The aims of the present study were to determine the tracheal intubating conditions, onset time, duration of action, and hemodynamic responses following the administration of cisatracurium 0.15 mg x kg(-1) to infants and children.

METHODS

One hundred and eighty-one infants and children aged 1 month to 12 years were randomized to two groups to receive anesthesia with nitrous oxide-oxygen-halothane (group H) or nitrous oxide-oxygen-thiopental-fentanyl (group TF). Intubation conditions were assessed 120 s after cisatracurium administration using a 4-part scale. Neuromuscular transmission was monitored by recording the evoked compound electromyogram of the adductor pollicis.

RESULTS

The proportion of patients with excellent or good intubating conditions was similar in both groups (88 of 90, 98% in group H; 85 of 90, 94% in group TF). However, there was a significantly greater proportion of excellent intubating conditions in group H (79 of 90, 88%) compared with group TF (65 of 90, 72%) (P = 0.01) and recovery time was significantly longer in group H compared with group TF (P < 0.001). There was also a higher proportion of excellent intubating conditions in infants compared with older subjects (P = 0.02) and a shorter onset time (P < 0.001) and longer recovery time (P < 0.001) in younger compared with older patients. Changes in heart rate and arterial pressure were negligible 1 min following the cisatracurium administration.

CONCLUSIONS

Cisatracurium 0.15 mg x kg(-1) produces acceptable intubating conditions at 120 s in the great majority of infants and children. Anesthesia background and age have significant effects on intubating conditions and duration of action of cisatracurium.

Authors+Show Affiliations

Department of Anaesthesia, Royal Manchester Children's Hospital, Pendlebury, Manchester, UK. george.meakin@manchester.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17238881

Citation

Meakin, George H., et al. "Tracheal Intubating Conditions and Pharmacodynamics Following Cisatracurium in Infants and Children Undergoing Halothane and Thiopental-fentanyl Anesthesia." Paediatric Anaesthesia, vol. 17, no. 2, 2007, pp. 113-20.
Meakin GH, Meretoja OA, Perkins RJ, et al. Tracheal intubating conditions and pharmacodynamics following cisatracurium in infants and children undergoing halothane and thiopental-fentanyl anesthesia. Paediatr Anaesth. 2007;17(2):113-20.
Meakin, G. H., Meretoja, O. A., Perkins, R. J., Waite, I., Taivainen, T., Wirtavuori, K., Murphy, A. K., & Raiha, L. (2007). Tracheal intubating conditions and pharmacodynamics following cisatracurium in infants and children undergoing halothane and thiopental-fentanyl anesthesia. Paediatric Anaesthesia, 17(2), 113-20.
Meakin GH, et al. Tracheal Intubating Conditions and Pharmacodynamics Following Cisatracurium in Infants and Children Undergoing Halothane and Thiopental-fentanyl Anesthesia. Paediatr Anaesth. 2007;17(2):113-20. PubMed PMID: 17238881.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tracheal intubating conditions and pharmacodynamics following cisatracurium in infants and children undergoing halothane and thiopental-fentanyl anesthesia. AU - Meakin,George H, AU - Meretoja,Olli A, AU - Perkins,Russell J, AU - Waite,Ian, AU - Taivainen,Tomi, AU - Wirtavuori,Kari, AU - Murphy,Anthony K, AU - Raiha,Leena, PY - 2007/1/24/pubmed PY - 2007/4/3/medline PY - 2007/1/24/entrez SP - 113 EP - 20 JF - Paediatric anaesthesia JO - Paediatr Anaesth VL - 17 IS - 2 N2 - BACKGROUND: The aims of the present study were to determine the tracheal intubating conditions, onset time, duration of action, and hemodynamic responses following the administration of cisatracurium 0.15 mg x kg(-1) to infants and children. METHODS: One hundred and eighty-one infants and children aged 1 month to 12 years were randomized to two groups to receive anesthesia with nitrous oxide-oxygen-halothane (group H) or nitrous oxide-oxygen-thiopental-fentanyl (group TF). Intubation conditions were assessed 120 s after cisatracurium administration using a 4-part scale. Neuromuscular transmission was monitored by recording the evoked compound electromyogram of the adductor pollicis. RESULTS: The proportion of patients with excellent or good intubating conditions was similar in both groups (88 of 90, 98% in group H; 85 of 90, 94% in group TF). However, there was a significantly greater proportion of excellent intubating conditions in group H (79 of 90, 88%) compared with group TF (65 of 90, 72%) (P = 0.01) and recovery time was significantly longer in group H compared with group TF (P < 0.001). There was also a higher proportion of excellent intubating conditions in infants compared with older subjects (P = 0.02) and a shorter onset time (P < 0.001) and longer recovery time (P < 0.001) in younger compared with older patients. Changes in heart rate and arterial pressure were negligible 1 min following the cisatracurium administration. CONCLUSIONS: Cisatracurium 0.15 mg x kg(-1) produces acceptable intubating conditions at 120 s in the great majority of infants and children. Anesthesia background and age have significant effects on intubating conditions and duration of action of cisatracurium. SN - 1155-5645 UR - https://www.unboundmedicine.com/medline/citation/17238881/Tracheal_intubating_conditions_and_pharmacodynamics_following_cisatracurium_in_infants_and_children_undergoing_halothane_and_thiopental_fentanyl_anesthesia_ L2 - https://doi.org/10.1111/j.1460-9592.2006.02042.x DB - PRIME DP - Unbound Medicine ER -