A dose-ranging study of rapacuronium in pediatric patients / George H. Meakin, M.B., Ch.B., M.D., F.R.C.A., Otli A. Meretoja, M.D., Ph.D., Johann Motsch, NI.D., Torni Taivainen, M.D., Ph.D., Kari Wirtavuori, M.D., Rüdiger Schönstedt, M.D., Russell Perkins, M.B., B.S., F.R.C.A., Anthony McCluskey, M.B., Ch.B., F.R.C.A.

BACKGROUND: The aim of this study was to determine the dose or doses of the new rapid-onset, short-acting, neuromuscular blocking drug rapacuronium that would provide satisfactory conditions for tracheal intubation at 60 s in infants and children. METHODS: Sixty-five infants (< 1 yr), 51 younger children (1-6 yr), and 49 older children (7-12 yr) were studied. Anesthesia was induced with thiopental-nitrous oxide-oxygen. Tracheal intubation was attempted 60 s after administration of one of five doses of rapacuronium (0.5, 1.0, 1.5, 2.0, or 2.5 mg/kg) and intubating conditions were assessed using a four-point scale. Following tracheal intubation, anesthesia was maintained with nitrous oxide-oxygen and alfentanil (12.5-50 microg/kg) as necessary. Neuromuscular transmission was monitored in an uncalibrated fashion using an acceleromyograph. RESULTS: Intubating conditions were good or excellent at 60 s in all infants after doses of 1.5 mg/kg or more and in all younger and older children after doses of 2.0 mg/kg or more. The duration of action of rapacuronium was dose- and age-dependent. Mean times to reappearance of the third twitch of the train-of-four (TOF; T3) were less than 10 min in infants at doses of 1.5 mg/kg or less and in younger and older children at doses of 2.0 mg/kg or less. Recovery of T3 after 1.0-2.0 mg/kg rapacuronium was significantly slower in infants compared with younger (P = 0.001) and older (P = 0.02) children. Five adverse experiences were related to rapacuronium administration: Bronchospasm (two instances), tachycardia (one instance), and increased salivation (two instances). None were serious. CONCLUSIONS: Doses of 1.5 and 2.0 mg/kg rapacuronium can produce satisfactory intubating conditions at 60 s in anesthetized infants and children, respectively, and are associated with a short duration of action..

Medienart:

E-Artikel

Erscheinungsjahr:

April 2000

2000

Erschienen:

April 2000

Enthalten in:

Zur Gesamtaufnahme - volume:92

Enthalten in:

Anesthesiology - 92(2000), 4, Seite 1002-1009

Sprache:

Englisch

Beteiligte Personen:

Meakin, George H. [VerfasserIn]
Motsch, Johann, 1952- [VerfasserIn]
Schönstedt, Rüdiger [VerfasserIn]

Links:

Volltext

Themen:

Age Factors
Anesthesia, General
Child
Child, Preschool
Dose-Response Relationship, Drug
Double-Blind Method
Electrocardiography
Female
Humans
Infant
Intubation, Intratracheal
Male
Myography
Neuromuscular Nondepolarizing Agents
Prospective Studies
Synaptic Transmission
Vecuronium Bromide

Anmerkungen:

Gesehen am 01.12.2017

Umfang:

8

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

1565951689

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