Effects of Bolus Administration of ORG-9426 in Children during Nitrous Oxide–Halothane Anesthesia

Woelfel, S. K.; Brandom, Barbara W.; Cook, David; Sarner, J. B.

doi:10.1097/00000542-199206000-00011

Cited by 79 publications

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“…The ED 95 of rocuronium found in the present study is in agreement with results obtained previously in children during either nitrous oxide-halothane [3,13] or nitrous oxide-barbiturate-opioid anaesthesia [14]. It is also comparable with results found in adults [14,15] but appears somewhat greater than a value obtained in infants receiving balanced anaesthesia (255 mg.kg ¹1 ) [14].…”

Section: Discussionsupporting

confidence: 92%

“…The onset of complete neuromuscular blockade in about 60 s following a dose of rocuronium 0.6 mg.kg ¹1 in the present study agrees with previous studies in infants, children and adults [2, 3,6]. This rapid onset of action is believed to be the result of reduced potency, necessitating administration of a larger dose of the drug [16,17].…”

Section: Discussionsupporting

confidence: 91%

“…Rocuronium is a recently introduced steroid nondepolarising neuromuscular blocking drug with a rapid onset, an intermediate duration of action and relatively low potency [1][2][3]. In view of its rapid onset of action, rocuronium may be an alternative to suxamethonium when rapid intubation of the trachea is required [4,5].…”

mentioning

confidence: 99%

“…In view of its rapid onset of action, rocuronium may be an alternative to suxamethonium when rapid intubation of the trachea is required [4,5]. While several authors have quantified the neuromuscular blocking effects of rocuronium in children in terms of twitch depression [3,6,7], there is little information concerning the minimum time to achieve satisfactory intubation conditions. Therefore, in the present study we were interested to determine the effective dose for 95% depression of thumb twitch (ED 95 ), the onset time and duration after a dose of approximately twice the ED 95 and the effective times for satisfactory intubation conditions in 50% and 90% of children.…”

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confidence: 99%

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Dose–response relationship and effective time to satisfactory intubation conditions after rocuronium in children

et al. 1997

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SummaryWe assessed the neuromuscular blocking effects of, and intubation conditions following, rocuronium in 81 children aged 2-12 years. The study was conducted in three parts. Parts 1 and 2 were undertaken during anaesthesia with thiopentone, alfentanil and nitrous oxide. Neuromuscular blockade was evaluated by recording the force of contraction of the adductor pollicis in response to train-of-four stimulation at 2 Hz repeated every 10 s. In Part 1 the potency of rocuronium was determined in 15 children using a single dose-response technique; in Part 2 onset and recovery times were determined in six children following rocuronium 0.6 mg.kg ¹1 . In Part 3 of the study, intubation conditions were assessed in five groups of 12 children whose tracheas were intubated 30, 40, 50, 60 and 70 s after rocuronium 0.6 mg.kg ¹1 during anaesthesia with thiopentone. The times to satisfactory intubation conditions in 50% and 90% of children were determined by probit analysis. The effective doses of rocuronium to produce 50% and 95% twitch depression were 151 mg. ...................................................................................... Correspondence to: Dr G. Meakin Accepted: 10 November 1996 Rocuronium is a recently introduced steroid nondepolarising neuromuscular blocking drug with a rapid onset, an intermediate duration of action and relatively low potency [1][2][3]. In view of its rapid onset of action, rocuronium may be an alternative to suxamethonium when rapid intubation of the trachea is required [4,5]. While several authors have quantified the neuromuscular blocking effects of rocuronium in children in terms of twitch depression [3,6,7], there is little information concerning the minimum time to achieve satisfactory intubation conditions. Therefore, in the present study we were interested to determine the effective dose for 95% depression of thumb twitch (ED 95 ), the onset time and duration after a dose of approximately twice the ED 95 and the effective times for satisfactory intubation conditions in 50% and 90% of children. Methods

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

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confidence: 99%

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Dose–response relationship and effective time to satisfactory intubation conditions after rocuronium in children

et al. 1997

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“…In children aged two to ten years, 0.4 mg·kg -1 rocuronium was shown to be the ED 9 5 value 1 7 but, for a mean onset time of 46-48 sec at the adductor pollicis, a dose of 0.6-0.8 mg·kg -1 was required. 17,18 In consideration of the wide interindividual variability, the duration of action of this dose is too long for most of the procedures characteristic of our clinical practice. In the present study, 0.4 mg·kg -1 rocuronium after propofol resulted in good jaw relaxation and open vocal cords in all children.…”

Section: Discussionmentioning

confidence: 99%

Tracheal intubation after induction of anesthesia in children with propofol — remifentanil or propofol-rocuronium

Klemola

Hiller

2000

Can J Anesth/J Can Anesth

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Purpose: To compare the intubating conditions after remifentanil-propofol with those after propofol-rocuronium combination with the aim of determining the optimal dose of remifentanil.Methods: In a randomized, double-blind study 80 healthy children aged three to nine years were assigned to one of four groups (n=20): 2 or 4 µg·kg -1 remifentanil (Re2 or Re4); 2 µg·kg -1 remifentanil and 0.2 mg·kg -1 rocuronium (Re2-Ro0.2); 0.4 mg·kg -1 rocuronium (Ro0.4). After atropine, remifentanil was injected over 30 sec followed by 3.5 mg·kg -1 propofol and rocuronium. After 60 sec, laryngoscopy and intubation were attempted. Intubating conditions were assessed as excellent, good or poor based on ease of ventilation, jaw relaxation, position of the vocal cords, and coughing to intubation.Results: In all children intubation was successful. Overall intubating conditions were better (P < 0.01), and the frequency of excellent conditions, 85%, was higher (P < 0.01) in the Re4 group than in the Ro0.4 group. No child manifested signs of muscular rigidity. In the remifentanil groups, arterial pressure decreased 11-13% and heart rate 6-9% after anesthetic induction, and remained at that level throughout the study. Conclusion:The best intubating conditions were produced by the combination of 4 µg·kg -1 remifentanil and 3.5 mg·kg -1 propofol. It provided excellent or good intubating conditions in all children without causing undue cardiovascular depression.Objectif : Comparer les conditions d'intubation après l'usage d'une combinaison de rémifentanil-propofol avec celles d'une combinaison de propofol-rocuronium dans le but de déterminer la dose optimale de rémifentanil.Méthode : Lors d'une étude randomisée et à double insu, 80 enfants en bonne santé, de trois à neuf ans, ont été répartis en quatre groupes (n=20) et ont reçu : 2 ou 4 µg·kg -1 de rémifentanil (Ré2 ou Ré4); 2 µg·kg -1 de rémifentanil et 0,2 mg·kg -1 de rocuronium (Ré2-Ro0,2); 0,4 mg·kg -1 de rocuronium. Après l'administration d'atropine, le rémifentanil a été injecté pendant 30 s et a été suivi de 3,5 mg·kg -1 de propofol et de rocuronium. La laryngoscopie et l'intubation ont été tentées après 60 s. Les conditions d'intubation ont été évaluées comme excellentes, bonnes ou pauvres selon la facilité de la ventilation, la relaxation de la mâchoire, la position des cordes vocales et la toux pendant l'intubation.Résultats : L'intubation a été réussie chez tous les enfants. Les conditions générales d'intubation ont été meilleures (P < 0,01), et la fréquence d'excellentes conditions, 85 %, plus élevée (P < 0,01) dans le groupe Ré4 que dans le groupe Ro0,4. Aucun enfant n'a manifesté de signe de rigidité musculaire. Dans les groupes rémifen-tanil, la tension artérielle a baissé de 11-13 % et la fréquence cardiaque de 6-9 % après l'induction de l'anesthésie et sont demeurées à ce niveau tout au long de l'étude. Conclusion :Les meilleures conditions d'intubation ont été réalisées avec la combinaison de 4 µg·kg -1 de rémifentanil et de 3,5 mg·kg -1 de propofol. L'intubation a été bo...

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Potentiation of Mivacurium by Rocuronium Is Age‐ and Time‐Dependent: A Study in Children, Adolescents, and Young and Elderly Adults

Goudsouzian

Martyn

1997

The Journal of Clinical Pharma

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Potentiation occurs when the steroidal muscle relaxant, rocuronium, is coadministered with the benzylisoquinolinium relaxant, mivacurium. The effect of time and age on this interaction was evaluated in four predetermined groups: children, adolescents, young adults, and elderly adults (15 per group) by monitoring the ulnar nerve-evoked force of contraction of the adductor pollicis (twitch response). During recovery from paralysis induced by 800 micrograms/kg of rocuronium, an infusion of mivacurium was started and maintained for at least 90 minutes to retain the twitch response at 1% to 9% of baseline tension (95 +/- 4% paralysis). Rocuronium at 600 micrograms/kg induced greater than 95% paralysis in 57 of the 60 patients within 2.2 +/- 0.4 (mean +/- SE) minutes. The period of recovery from rocuronium-induced paralysis to 5% of baseline twitch height was longest in the elderly (30.1 +/- 2.9 minutes) and shortest in the adolescents (16.5 +/- 2.4 minutes). The mivacurium infusion requirements to maintain 95 +/- 4% paralysis was highest in children and progressively increased with time. In young and elderly adults, the infusion rates remained lower than that of children and did not change with time. The incidence of satisfactory spontaneous recovery within 20 minutes (train-of-four ratio > 75%) was the highest in children, followed by adolescents and young adults, and was least in the elderly. The residual neuromuscular effect of rocuronium on the subsequent mivacurium infusion was most pronounced in the elderly, followed by young adults, then adolescents, and was least in children.

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Effects of Bolus Administration of ORG-9426 in Children during Nitrous Oxide–Halothane Anesthesia

Cited by 79 publications

References 0 publications

Dose–response relationship and effective time to satisfactory intubation conditions after rocuronium in children

Dose–response relationship and effective time to satisfactory intubation conditions after rocuronium in children

Tracheal intubation after induction of anesthesia in children with propofol — remifentanil or propofol-rocuronium

Potentiation of Mivacurium by Rocuronium Is Age‐ and Time‐Dependent: A Study in Children, Adolescents, and Young and Elderly Adults

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