Prevention of rocuronium‐induced withdrawal movement in children: a comparison of remifentanil with alfentanil

Kim, Jong Yeop; Kwak, Hyun Jeong; Kim, Ji Young; Park, Kwan Sik; Song, Jae Seok

doi:10.1111/j.1460-9592.2007.02390.x

Cited by 16 publications

(18 citation statements)

References 17 publications

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“…Remifentanil 1 or 0.5 lg/kg was already known to be effective in preventing rocuronium-induced withdrawal movement [15]. The incidence of withdrawal movements was reduced further with remifentanil at 1 lg/kg compared with that at 0.5 lg/kg.…”

Section: Discussionmentioning

confidence: 96%

EC50 of remifentanil to prevent withdrawal movement associated with injection of rocuronium

et al. 2010

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Section: Discussionmentioning

confidence: 96%

EC50 of remifentanil to prevent withdrawal movement associated with injection of rocuronium

et al. 2010

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“…Although the higher dose of alfentanil could improve the intubation conditions of the control group in children, we have been concerned about hemodynamic instability and chest wall Values are expressed as mean ± SD T0, baseline (before induction); T1, after test drug (ketamine or saline) injection; T2, after alfentanil injection; T3, before intubation; T4, 1 min after intubation; T5, 3 min after intubation * P \ 0.05, versus control group P \ 0.05, versus baseline values (T0) within the group rigidity before tracheal intubation during sevoflurane induction with higher doses. In a previous study, the higher dose of alfentanil (15 lg/kg) was reported to cause significant decrease in MAP and HR before intubation during propofol induction in children [19]. Further studies exploring the effect of ketamine in improving intubation conditions and hemodynamic instability during sevoflurane induction with the higher doses of opioids without muscle relaxant are justified.…”

Section: Discussionmentioning

confidence: 99%

The effect of ketamine on tracheal intubating conditions without neuromuscular blockade during sevoflurane induction in children

et al. 2011

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Purpose The purpose of this study was to investigate the effect of ketamine on intubating conditions for tracheal intubation during anesthesia induction with sevoflurane and alfentanil in pediatric patients. Methods After obtaining parental consents, 50 children, aged 3-10 years, were randomly allocated into two groups to receive either i.v. ketamine 0.5 mg/kg (ketamine group, n = 25) or i.v. saline 5 ml (control saline group, n = 25). One minute after injection of the study drug (ketamine or saline), anesthesia was induced with 5% sevoflurane, followed by injection of alfentanil 10 lg/kg 1 min later. The trachea was intubated 4 min after inhalational induction of anesthesia. Acceptable intubation was defined as excellent or good intubating conditions. Mean arterial pressure (MAP) and heart rate (HR) were recorded during the induction period. Results The percentage of patients with acceptable intubating conditions was higher in the ketamine group (87%) than in the control group (52%) (P = 0.0129). MAP before intubation was significantly lower in the control group than in the ketamine group (P = 0.001).Conclusion This study demonstrated that administration of ketamine 0.5 mg/kg could improve intubating conditions for tracheal intubation without neuromuscular blockade and preserve hemodynamic stability during sevoflurane inhalation induction with alfentanil in children.

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“…In addition, remifentanil can prevent the withdrawal response associated with rocuronium injection. 17 A retrospective review of 287 cases of rigid bronchoscopic FBA removal showed incidence rates of adverse events related to anesthesia and surgery were 0.7% and 7.6%, respectively. 10 The most common adverse event related to anesthesia was laryngospasm.…”

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confidence: 99%

Anesthesia with propofol‐remifentanil combined with rocuronium for bronchial foreign body removal in children: Experience of 2 886 cases

Qiu

et al. 2018

Pediatric Investigation

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Importance: The appropriate anesthetic method can reduce the complications of children with tracheal foreign body and reduce the mortality rate of children. What kind of anesthetic method to choose has always been the focus of debate. Purpose: To evaluate the efficacy and safety of anesthesia with propofolremifentanil combined with rocuronium for foreign body aspiration (FBA) removal with the positive-pressure ventilation technique. Methods: Medical records of patients who underwent bronchoscopy for evaluation of FBA in our unit from January 2015 to January 2018 were retrospectively reviewed. Demographic data (age and sex), nature of foreign body and location, complications, length of hospital stay and outcome were analyzed. Results: A total of 2 886 children were included in this study. The median age was 24 months (8 months to 10 years). FBA was detected and removed in 95.6% of patients. The average operation time was 17 ± 5 min and average length of hospital stay was 2 days. Observed peri-interventional complications included desaturation (n = 66), laryngospasm (n = 19), laryngeal or subglottic edema (n = 15), irritating cough (n = 3), body movement (n = 76) and pneumonia (n = 206). No deaths occurred during hospitalization or follow-up in this series. Interpretation: Anesthesia with propofol-remifentanil combined with rocuronium under positive-pressure ventilation is an effective and safe technique during FBA removal in children.

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Prevention of rocuronium‐induced withdrawal movement in children: a comparison of remifentanil with alfentanil

Abstract: Both remifentanil 1 microg.kg(-1) and alfentanil 15 microg.kg(-1) can be used to prevent rocuronium-associated withdrawal movement in children because they are equally effective and attenuate the increase in MAP and HR after intubation.

Cited by 16 publications

References 17 publications

EC50 of remifentanil to prevent withdrawal movement associated with injection of rocuronium

EC50 of remifentanil to prevent withdrawal movement associated with injection of rocuronium

The effect of ketamine on tracheal intubating conditions without neuromuscular blockade during sevoflurane induction in children

Anesthesia with propofol‐remifentanil combined with rocuronium for bronchial foreign body removal in children: Experience of 2 886 cases

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