Neuromuscular recovery following rocuronium bromide single dose in infants
Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influenc...
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| Autor*in: |
Rapp, H.-J. - MD [verfasserIn] Altenmueller, C.A. - MD [verfasserIn] Waschke, C. - MD [verfasserIn] |
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E-Artikel |
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| Erschienen: |
Oxford, UK: Blackwell Publishing Ltd ; 2004 |
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Online-Ressource |
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| Reproduktion: |
2004 ; Blackwell Publishing Journal Backfiles 1879-2005 |
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| Übergeordnetes Werk: |
In: Pediatric anesthesia - Oxford [u.a.] : Wiley-Blackwell, 1991, 14(2004), 4, Seite 0 |
| Übergeordnetes Werk: |
volume:14 ; year:2004 ; number:4 ; pages:0 |
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| DOI / URN: |
10.1046/j.1460-9592.2003.01216.x |
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| Katalog-ID: |
NLEJ243867441 |
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| 245 | 1 | 0 | |a Neuromuscular recovery following rocuronium bromide single dose in infants |
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| 520 | |a Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants. | ||
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| 700 | 1 | |a Altenmueller, C.A. |c MD |e verfasserin |4 aut | |
| 700 | 1 | |a Waschke, C. |c MD |e verfasserin |4 aut | |
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10.1046/j.1460-9592.2003.01216.x doi (DE-627)NLEJ243867441 DE-627 ger DE-627 rakwb Rapp, H.-J. MD verfasserin aut Neuromuscular recovery following rocuronium bromide single dose in infants Oxford, UK Blackwell Publishing Ltd 2004 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants. 2004 Blackwell Publishing Journal Backfiles 1879-2005 |2004|||||||||| muscle relaxant Altenmueller, C.A. MD verfasserin aut Waschke, C. MD verfasserin aut In Pediatric anesthesia Oxford [u.a.] : Wiley-Blackwell, 1991 14(2004), 4, Seite 0 Online-Ressource (DE-627)NLEJ243926200 (DE-600)2008564-3 1460-9592 nnns volume:14 year:2004 number:4 pages:0 http://dx.doi.org/10.1046/j.1460-9592.2003.01216.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 14 2004 4 0 |
| spelling |
10.1046/j.1460-9592.2003.01216.x doi (DE-627)NLEJ243867441 DE-627 ger DE-627 rakwb Rapp, H.-J. MD verfasserin aut Neuromuscular recovery following rocuronium bromide single dose in infants Oxford, UK Blackwell Publishing Ltd 2004 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants. 2004 Blackwell Publishing Journal Backfiles 1879-2005 |2004|||||||||| muscle relaxant Altenmueller, C.A. MD verfasserin aut Waschke, C. MD verfasserin aut In Pediatric anesthesia Oxford [u.a.] : Wiley-Blackwell, 1991 14(2004), 4, Seite 0 Online-Ressource (DE-627)NLEJ243926200 (DE-600)2008564-3 1460-9592 nnns volume:14 year:2004 number:4 pages:0 http://dx.doi.org/10.1046/j.1460-9592.2003.01216.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 14 2004 4 0 |
| allfields_unstemmed |
10.1046/j.1460-9592.2003.01216.x doi (DE-627)NLEJ243867441 DE-627 ger DE-627 rakwb Rapp, H.-J. MD verfasserin aut Neuromuscular recovery following rocuronium bromide single dose in infants Oxford, UK Blackwell Publishing Ltd 2004 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants. 2004 Blackwell Publishing Journal Backfiles 1879-2005 |2004|||||||||| muscle relaxant Altenmueller, C.A. MD verfasserin aut Waschke, C. MD verfasserin aut In Pediatric anesthesia Oxford [u.a.] : Wiley-Blackwell, 1991 14(2004), 4, Seite 0 Online-Ressource (DE-627)NLEJ243926200 (DE-600)2008564-3 1460-9592 nnns volume:14 year:2004 number:4 pages:0 http://dx.doi.org/10.1046/j.1460-9592.2003.01216.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 14 2004 4 0 |
| allfieldsGer |
10.1046/j.1460-9592.2003.01216.x doi (DE-627)NLEJ243867441 DE-627 ger DE-627 rakwb Rapp, H.-J. MD verfasserin aut Neuromuscular recovery following rocuronium bromide single dose in infants Oxford, UK Blackwell Publishing Ltd 2004 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants. 2004 Blackwell Publishing Journal Backfiles 1879-2005 |2004|||||||||| muscle relaxant Altenmueller, C.A. MD verfasserin aut Waschke, C. MD verfasserin aut In Pediatric anesthesia Oxford [u.a.] : Wiley-Blackwell, 1991 14(2004), 4, Seite 0 Online-Ressource (DE-627)NLEJ243926200 (DE-600)2008564-3 1460-9592 nnns volume:14 year:2004 number:4 pages:0 http://dx.doi.org/10.1046/j.1460-9592.2003.01216.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 14 2004 4 0 |
| allfieldsSound |
10.1046/j.1460-9592.2003.01216.x doi (DE-627)NLEJ243867441 DE-627 ger DE-627 rakwb Rapp, H.-J. MD verfasserin aut Neuromuscular recovery following rocuronium bromide single dose in infants Oxford, UK Blackwell Publishing Ltd 2004 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants. 2004 Blackwell Publishing Journal Backfiles 1879-2005 |2004|||||||||| muscle relaxant Altenmueller, C.A. MD verfasserin aut Waschke, C. MD verfasserin aut In Pediatric anesthesia Oxford [u.a.] : Wiley-Blackwell, 1991 14(2004), 4, Seite 0 Online-Ressource (DE-627)NLEJ243926200 (DE-600)2008564-3 1460-9592 nnns volume:14 year:2004 number:4 pages:0 http://dx.doi.org/10.1046/j.1460-9592.2003.01216.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 14 2004 4 0 |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">NLEJ243867441</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20210707190733.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">120427s2004 xx |||||o 00| ||und c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1046/j.1460-9592.2003.01216.x</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)NLEJ243867441</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Rapp, H.-J.</subfield><subfield code="c">MD</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Neuromuscular recovery following rocuronium bromide single dose in infants</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="a">Oxford, UK</subfield><subfield code="b">Blackwell Publishing Ltd</subfield><subfield code="c">2004</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">z</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zu</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants.</subfield></datafield><datafield tag="533" ind1=" " ind2=" "><subfield code="d">2004</subfield><subfield code="f">Blackwell Publishing Journal Backfiles 1879-2005</subfield><subfield code="7">|2004||||||||||</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">muscle relaxant</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Altenmueller, C.A.</subfield><subfield code="c">MD</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Waschke, C.</subfield><subfield code="c">MD</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">Pediatric anesthesia</subfield><subfield code="d">Oxford [u.a.] : Wiley-Blackwell, 1991</subfield><subfield code="g">14(2004), 4, Seite 0</subfield><subfield code="h">Online-Ressource</subfield><subfield code="w">(DE-627)NLEJ243926200</subfield><subfield code="w">(DE-600)2008564-3</subfield><subfield code="x">1460-9592</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:14</subfield><subfield code="g">year:2004</subfield><subfield code="g">number:4</subfield><subfield code="g">pages:0</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">http://dx.doi.org/10.1046/j.1460-9592.2003.01216.x</subfield><subfield code="q">text/html</subfield><subfield code="x">Verlag</subfield><subfield code="z">Deutschlandweit zugänglich</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_U</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">ZDB-1-DJB</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_NL_ARTICLE</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">14</subfield><subfield code="j">2004</subfield><subfield code="e">4</subfield><subfield code="h">0</subfield></datafield></record></collection>
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Neuromuscular recovery following rocuronium bromide single dose in infants muscle relaxant |
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neuromuscular recovery following rocuronium bromide single dose in infants |
| title_auth |
Neuromuscular recovery following rocuronium bromide single dose in infants |
| abstract |
Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants. |
| abstractGer |
Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants. |
| abstract_unstemmed |
Background : Rocuronium bromide, a steroid nondepolarizing muscle relaxant, has a rapid onset and an intermediate duration of action in infants, children and adults. However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. Reduced doses of rocuronium should be used in newborns and small infants. |
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However, clinical evidence shows a longer duration of recovery in small infants. The aim of this study was to investigate the influence of age on rocuronium recovery during the first year of life.Methods : ASA I–II infants, scheduled for elective surgery under general anaesthesia and intubation were included after ethics committee approval and parents’ written consent. According to age the patients were randomly allocated to receive either 0.45 mg·kg−1 or 0.6 mg·kg−1 rocuronium bromide in three age-groups: (A) 0–1 month, (B) 2–4 months and (C) 5–12 months. After induction with thiopentone (5–7 mg·kg−1), anesthesia was maintained with isoflurane without opioids. Prior to surgery, caudal block with bupivacaine (0.125%) 1.0 ml·kg−1 and paracetamol 25 mg·kg−1 rectally were given for analgesia. Efficacy variables were intubation conditions 60 s after administration of muscle relaxant (T0) and recovery of neuromuscular blockade measured as T1 at 10, 25, 50 and 75 % of baseline, train-of-four (TOF) of 0.7 and Recovery Index (RI). Data were characterized by summary statistics and analysis of variance.Results : A total of 61 infants with a median age range of 67 (2–364) days were included. Intubation conditions were excellent or good in all dose and age groups. T0 in group A was reached in a range of 15–30 s, in others up to 60 s. T1 recovery (T75) after 0.45 mg·kg−1 was 56.4 ± 16 (A), 62.7 ± 32 (B) and 45.8 ± 18 (C) min. Recovery times for of 0.6 mg·kg−1 were 100.8 ± 35 (A), 70.6 ± 19 (B) and 63.4 ± 21 (C) min, respectively. The TOF ratio (0.7) was 62.3 ± 18 (A), 64.1 ± 27 (B) and 43.7 ± 12 (C) min using 0.45 mg·kg−1 compared with 94.8 ± 31 (A), 63.8 ± 14 (B) and 67.5 ± 18 (C) min with 0.6 mg·kg−1. The differences of T75 and TOF 0.7 in A and C were significant (P ≤ 0.05).Conclusions : Recovery of muscle relaxation using rocuronium bromide under isoflurane anesthesia in infants differs widely and shows great differences between age groups as well as dose regimen. A dose of 0.6 mg·kg−1 resulted in a significantly longer duration of action in group A. The reduced dose of 0.45 mg·kg−1 resulted in rapid and good relaxation in all infants without very long lasting effects. 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