Document Detail

Tracheal intubating conditions and pharmacodynamics following cisatracurium in infants and children undergoing halothane and thiopental-fentanyl anesthesia.
MedLine Citation:
PMID:  17238881     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aims of the present study were to determine the tracheal intubating conditions, onset time, duration of action, and hemodynamic responses following the administration of cisatracurium 0.15 mg x kg(-1) to infants and children. METHODS: One hundred and eighty-one infants and children aged 1 month to 12 years were randomized to two groups to receive anesthesia with nitrous oxide-oxygen-halothane (group H) or nitrous oxide-oxygen-thiopental-fentanyl (group TF). Intubation conditions were assessed 120 s after cisatracurium administration using a 4-part scale. Neuromuscular transmission was monitored by recording the evoked compound electromyogram of the adductor pollicis. RESULTS: The proportion of patients with excellent or good intubating conditions was similar in both groups (88 of 90, 98% in group H; 85 of 90, 94% in group TF). However, there was a significantly greater proportion of excellent intubating conditions in group H (79 of 90, 88%) compared with group TF (65 of 90, 72%) (P = 0.01) and recovery time was significantly longer in group H compared with group TF (P < 0.001). There was also a higher proportion of excellent intubating conditions in infants compared with older subjects (P = 0.02) and a shorter onset time (P < 0.001) and longer recovery time (P < 0.001) in younger compared with older patients. Changes in heart rate and arterial pressure were negligible 1 min following the cisatracurium administration. CONCLUSIONS: Cisatracurium 0.15 mg x kg(-1) produces acceptable intubating conditions at 120 s in the great majority of infants and children. Anesthesia background and age have significant effects on intubating conditions and duration of action of cisatracurium.
George H Meakin; Olli A Meretoja; Russell J Perkins; Ian Waite; Tomi Taivainen; Kari Wirtavuori; Anthony K Murphy; Leena Raiha
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  17     ISSN:  1155-5645     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-22     Completed Date:  2007-04-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  113-20     Citation Subset:  IM    
Department of Anaesthesia, Royal Manchester Children's Hospital, Pendlebury, Manchester, UK.
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MeSH Terms
Anesthesia Recovery Period
Anesthesia, General / methods*
Anesthetics, Combined / administration & dosage
Anesthetics, Inhalation / administration & dosage
Anesthetics, Intravenous / administration & dosage
Atracurium / adverse effects,  analogs & derivatives*,  pharmacology
Blood Pressure / drug effects
Child, Preschool
Electromyography / methods
Fentanyl / administration & dosage*
Halothane / administration & dosage*
Heart Rate / drug effects
Intubation, Intratracheal / methods*
Neuromuscular Blocking Agents / adverse effects,  pharmacology
Nitrous Oxide / administration & dosage
Oxygen / administration & dosage
Thiopental / administration & dosage*
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Anesthetics, Combined; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Neuromuscular Blocking Agents; 0/cisatracurium; 10024-97-2/Nitrous Oxide; 151-67-7/Halothane; 437-38-7/Fentanyl; 64228-79-1/Atracurium; 76-75-5/Thiopental; 7782-44-7/Oxygen

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