Document Detail


Use of low-dose rocuronium for intubation of children during volunteer surgery abroad.
MedLine Citation:
PMID:  16029399     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Low-dose rocuronium (ROC) might improve safety during volunteer surgery abroad (VSA) by facilitating intubation with a lower halothane concentration than is typically used. We hypothesized that 0.25 mg.kg(-1) of ROC would improve intubation conditions during 3% halothane induction and still allow for rapid return to spontaneous ventilation (SV). METHODS: During Operation Smile's 2002 mission to Honduras, patients aged 3 months-11 years were randomized to receive ROC 0.25 mg.kg(-1) (n = 19), or placebo (n = 23). Induction was with 3% halothane in 100% O(2), with ventilation assisted and controlled when possible, and normocarbia maintained. An i.v. was placed after induction, and ROC or placebo given. Direct laryngoscopy (DL) was performed 3 min later by a blinded laryngoscopist who assessed conditions according to predetermined criteria. RESULTS: Adequate intubation conditions occurred in 89 and 87% of patients (P = 0.59), and mean times from DL until the return to SV were 9.8 and 4.3 min (P = 0.003), in the ROC and placebo groups, respectively. For the placebo group, the presence of SV at DL was predictive of inadequate intubation conditions (P = 0.006). CONCLUSIONS: When administering 3% halothane for induction of VSA patients, a high frequency of adequate intubation conditions can be achieved without a relaxant, rendering the known benefits of 0.25 mg.kg(-1) of ROC unapparent. ROC 0.25 mg.kg(-1) does allow rapid return to SV.
Authors:
George D Politis; Judith Brill; John Jones
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  15     ISSN:  1155-5645     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-20     Completed Date:  2005-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  648-52     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA 22908, USA. gdp8a@virginia.edu
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Androstanols / administration & dosage*
Anesthetics, Inhalation / administration & dosage
Blood Pressure / drug effects
Child
Child, Preschool
Halothane / administration & dosage
Heart Rate / drug effects
Humans
Infant
Intubation, Intratracheal*
Laryngismus / etiology
Laryngoscopy
Medical Missions, Official*
Neuromuscular Nondepolarizing Agents / administration & dosage*
Oxygen / administration & dosage
Placebos
Respiration / drug effects
Respiration, Artificial
Safety
Surgical Procedures, Operative*
Time Factors
Chemical
Reg. No./Substance:
0/Androstanols; 0/Anesthetics, Inhalation; 0/Neuromuscular Nondepolarizing Agents; 0/Placebos; 143558-00-3/rocuronium; 151-67-7/Halothane; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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