Premium
Tracheal intubating conditions and pharmacodynamics following cisatracurium in infants and children undergoing halothane and thiopental‐fentanyl anesthesia
Author(s) -
MEAKIN GEORGE H.,
MERETOJA OLLI A.,
PERKINS RUSSELL J.,
WAITE IAN,
TAIVAINEN TOMI,
WIRTAVUORI KARI,
MURPHY ANTHONY K.,
RAIHA LEENA
Publication year - 2007
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.1460-9592.2006.02042.x
Subject(s) - medicine , fentanyl , anesthesia , halothane , tracheal intubation , intubation , nitrous oxide , pharmacodynamics , heart rate , adductor pollicis muscle , hemodynamics , pharmacokinetics , blood pressure , surgery , elbow , ulnar nerve
Summary 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·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·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.