A dose-ranging study of rapacuronium in pediatric patients

• Verfasst von: Meakin, George H. [VerfasserIn]
• Verfasst von: Motsch, Johann [VerfasserIn]
• Verfasst von: Schönstedt, Rüdiger [VerfasserIn]
• Titel: A dose-ranging study of rapacuronium in pediatric patients
• Verf.angabe: 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.
• Umfang: 8 S.
• Fussnoten: Gesehen am 01.12.2017
• Titel Quelle: Enthalten in: Anesthesiology
• Jahr Quelle: 2000
• Band/Heft Quelle: 92(2000), 4, S. 1002-1009
• ISSN Quelle: 1528-1175
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1565951689

Abstract

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.