Naslov
Recovery characteristics after propofol anesthesia with low dose rocuronium for day-case tonsillectomy in children

Autori
Bartolek, Dubravka ; Šakić, Kata ; Lajtman, Zoran

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstract of the 79th Clinical and Scientific Congress of International Anesthesia Research Society (IARS 2005) / Anesthesia and analgesia / - , 2005, S-328

Skup
IARS Clinical and Scientific Congress (79 ; 2005)

Mjesto i datum
Honolulu (HI), Sjedinjene Američke Države, 11.03.2005. - 15.03.2005

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
rocuronium ; tonsillectomy ; pediatric anesthesia

Sažetak
Low doses of rocuronium have proved acceptable intubating condition under different anesthesia conditions in children 1, 2. The recovery charactetistics for low dose rocuronium are still not fully described. We compared recovery characteristics as onset time, duration and spontaneus recovery of neuromuscular block during propofol anaesthesia followed by 0.45 and 0.60 mg kg -1rocuronium in children for day case tonsillectomy. Sixty children (8-12 old, both sexes, ASA I/II status) were studied in the prospective, randomised, double-blinded study. All children were premedicated with midazolam 0.3 mg kg-1 and EMLA was placed on the left fist. Anaesthesia was induced with propofol 2, 5 mg kg-1 and maintained by continuous infusion of propofol 0.1 mg kg-1min-1 and alfentanyl 0.0015 mg kg-1min-1 with 50 % oxygen in nitrous oxide. According to randomization schedule the appropriate intravenous bolus of neuromuscular blocking drug was given in thirty children, in standard (0.6 mg kg-1)(R1) or in low-dose (0.45 mg kg-1)(R2). Neuromuscular transmission was monitored by means of acceleromyography with supramaximal train-of-four stimulation of the ulnar nerve with frequency of 1 Hz. Endotracheal intubation was performed at maximal depression of the first twitch (T1). Intubating conditions were assessed using the standard three- point scoring system. After tonsillectomy, infusion of propofol was stoped when 90% control twitch height of TOF was establish. At that time the extubation was carried out. All patients were scored for their clinical recovery by the Steward-scoring system. The data were analysed using the Chi-Square test, the Mann-Whitney U-test and Fisher's exact test. A P- value < 0.05 was considered as statistically significant. The groups were comparable with respect to age, sex, weight and height as ASA physical status. The mean duration of tonsillectomy was nearly equal in both groups (R1=19 +/- 1.6, R2=18 +/- 1.4 min). Duration of anaesthesia was significantly longer in R1 group (R1=39.2 +/- 0.7, R2=31 +/- 0.5 min)(p<0.05). Although the onset time(To) was significantly longer after a low-dose rocuronium (R2=3.1 +/- 0.4 ; R1=1.3 +/- 0.4 min) (p<0.05), no difference was found in the intubating conditions. Clinical duration of the block(T0-T25) was significantly shorter after low-dose rocuronium (R2=10.9 +/- 0.7 ; R1=18.8 +/- 1.0 min)(p<0.05) but recovery index(T25-T75) (R2=13.7 +/- 0.7 ; R1=14.1 +/- 0.5 min) and recovery time(T75-T90) (R2= 3.3 +/- 0.3, R1= 2.9 +/- 0.2) did not differ between the groups (p>0.05). Under continuous propofol- alfentanyl-N2O anaesthesia, low-dose rocuronium in children results in the longer onset time and shorter clinical duration. Spontaneus recovery of neuromuscular block under continous propofol anesthesia in this circumstances is save and clinical acceptable. This technik is recommanded for tonsillectomy in children performed on day case basis where an intubation and shorter clinical duration of block is required. References: 1. Paediatric Anaesth. 2004 ; 14:636-41., 2. Br. J. Anaesth. 2002 ; 89:277- 81.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA