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Low doses of rocuronium during remifentanil–propofol‐based anesthesia in children: comparison of intubating conditions *
Author(s) -
Özteki̇n Sermi̇n,
Hepaǧuşlar Hasan,
Ki̇lerci̇k Hakan,
Kar Aysun Afi̇fe,
Boyaci Fi̇gen,
Elar Zahi̇de
Publication year - 2004
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2004.01273.x
Subject(s) - medicine , rocuronium , propofol , anesthesia , remifentanil , midazolam , intubation , bolus (digestion) , rocuronium bromide , laryngoscopy , heart rate , sedation , surgery , blood pressure , radiology
Summary 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· kg −1 . Following atropine 10 μ g·kg −1 , remifentanil infusion 0.5 μ g·kg −1 ·min −1 was started. After 60 s, anesthesia was induced with propofol 2.5 mg·kg −1 . Immediately after a bolus dose of propofol, the children received rocuronium doses of 0.15 mg·kg −1 (group I, n = 22) or 0.3 mg·kg −1 (group II, n = 22) in a randomized manner, after which an infusion of propofol 6 mg·kg −1 h −1 was added to the infusion of remifentanil 0.5 μ g·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·kg −1 of rocuronium may be a better low dose than 0.15 mg·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.