Comparison of rocuronium and vecuronium in paediatric cardiac surgery, using sevoflurane anaesthesia

Abstract

population. However, the haemodynamic effect of rocuronium in children with congenital heart disease, undergoing cardiac surgery remain incompletely characterised.The goal of this study was to compare intubating conditions and haemodynamic profile of equi-effective doses (3x ED 95) of rocuronium (0.9 mgkg -1 ) and vecuronium (0.2 mgkg -1 ) in paediatric patients undergoing cardiac surgery. Methods PatientsAfter obtaining local ethics committee approval and informed parents consent, we studied 40 ASA gr I to III, of both sexes, aged 2 days to 10 years (mean 5.08 years) and weighing 1.5 to 20 kg (mean 11.5 kg). This was a prospective, double-blind, comparative, randomised study in which both cyanotic and noncyanotic children were undergoing an elective open Abstract Aim. The goal was to study the haemodynamic effects and intubating conditions, of rocuronium, vs. vecuronium in paediatric patients undergoing elective cardiac surgery. The haemodymanic effects and intubating conditions, of rocuronium, in children undergoing cardiac surgery, remain incompletely characterised.Methods. A double blind randomised study was conducted in 40 children with congenital heart disease, undergoing open heart surgery. Patients were divided into 2 groups -Group A received rocuronium (0.9 mgkg -1 ) and Group B, vecuronium (0.2 mgkg -1 ) (n=20 in each group) Intubating conditions and haemodynamic profile were assessed at 60 seconds and at 90 seconds. Neuromuscular monitoring was established before muscle relaxant administration. Anaesthesia technique standardised with sevoflurane 7-8% in addition, was used in both groups.Results. Compared with vecuronium, rocuronium was associated with shorter onset time (60.2 ± 20.2 vs 88.6 ± 41.2 secs; P<0.001) and clinical duration of action (34.3 ± 8.4 vs 44.7 ± 6.2 min, P<0.001). According to standardised, intubation scores, intubation conditions, at 90 seconds in Group A was 90% and Group B 80%. However at 60 seconds they were 80% and 40% respectively. Haemodynamic stability in both the groups was similar, although one patient in Group B showed transient bradycardia and hypotension.Conclusion. Rocuronium showed better intubating conditions than vecuronium at 60 seconds in paediatric patients undergoing open heart surgery. (Ind J Thorac Cardiovasc Surg, 2002; 18: 105-109)

Spontaneous recovery from neuromuscular block after a single dose of a muscle relaxant in pediatric patients: A systematic review using a network meta‐analytic and meta‐regression approach

“…Electronic searches yielded 6345 potentially relevant trials, of which 71 (48 RCTs and 23 CCTs) eligible research papers (Figure 1 and Table S1) were identified, encompassing 4319 in the large majority ASA I‐II pediatric participants in 232 study arms 43–112 . We incorporated three RCTs that enrolled only a few ASA III patients 62,64,83 . The exclusion of these from the sensitivity analysis did not alter the overall results.…”

“…For the comparative outcome analysis of t25, a 26‐node treatment network was produced from 48 studies (41 RCTs and 7 CCTs) with 164 study arms, including 3224 pediatric participants 43–90 …”

“…We incorporated three RCTs that enrolled only a few ASA III patients. 62,64,83 The exclusion of these from the sensitivity analysis did not alter the overall results. Participants in the included trials were scheduled to undergo elective or emergency surgery requiring tracheal intubation and were recruited over a 41-year period (January 1983 to December 2023).…”