Optimal rocuronium dose for intubation during inhalation induction with sevoflurane in children
Optimal rocuronium dose for intubation during inhalation induction with sevoflurane in children
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DOI：
10.1093/bja/aef177
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发表时间：
2002-08-01
影响因子：
9.8
通讯作者：
Peters, J
中科院分区：
文献类型：
--
作者：
Eikermann, M;Hunkemöller, I;Peters, J
背景。我们采用前瞻性、随机、评估盲法研究了120名2-7岁的儿童，以确定在七氟醚吸入诱导过程中提供95%可接受插管条件（ED95TI）概率的最佳罗库溴铵剂量。在60%氧化亚氮和40%氧气中吸入8%七氟醚诱导后，睫毛反射丧失，我们给予罗库溴铵（0.1,0.15,0.22,0.3或0.6 mg kg(-1)）或安慰剂。我们量化神经肌肉功能，以0.1 Hz刺激尺神经，以产生拇内收肌收缩。注射试验药物2 min后评估插管情况。最佳罗库溴铵剂量被定义为最低剂量，95%的儿童（ED95TI）可以接受插管条件。注射安慰剂或罗库溴铵2分钟后，分别有35%、45%、80%、90%、95%和100%的儿童可接受插管条件。罗库溴铵0.07 [CI 0.02-0.11]、0.24[0.19-0.31]和0.29 [0.23-0.38]mg kg（-1）提供50%、90%和95%的可接受插管条件的概率。当拇指加速度降低50%或更多时，97%的儿童认为插管条件是可以接受的。罗库罗仑给药后平均12(7)、16(7)、24(7)、24(8)、50 (22)min，四列回收率分别为0.8。8%七氟醚在60%氧化亚氮中吸入诱导时，罗库溴铵0.29 mg kg(-1) （ED95）可优化短时间手术的插管条件。
Background. We studied 120 children aged 2-7 yr in a prospective, randomized, assessor-blinded fashion to define the optimal rocuronium dose which provides a 95% probability of acceptable intubation conditions (ED95TI) during inhalation induction with sevoflurane.Methods. After inhalation induction with 8% sevoflurane in 60% nitrous oxide and 40% oxygen, and loss of the eyelash reflex, we administered rocuronium (0.1, 0.15, 0.22, 0.3, or 0.6 mg kg(-1)) or placebo. We quantified neuromuscular function by stimulation of the ulnar nerve at 0.1 Hz to produce contraction of the adductor pollicis muscle using accelerometry. Intubation conditions were assessed 2 min after test drug injection. The optimal rocuronium dose was defined as the lowest dose, which allowed acceptable intubation conditions in 95% of children (ED95TI).Results. Two minutes after injection of placebo or rocuronium, intubation conditions were acceptable in 35, 45, 80, 90, 95, and 100% of children, respectively. Rocuronium 0.07 [CI 0.02-0.11], 0.24 [0.19-0.31], and 0.29 [0.23-0.38] mg kg(-1) provided 50, 90, and 95% probability of acceptable intubating conditions. When thumb acceleration was depressed by 50% or more, intubating conditions were considered acceptable in 97% of children. Recovery of the train-of-four ratio to 0.8 averaged 12 (7), 16 (7), 24 (7), 24 (8), and 50 (22) min after the respective dose of rocuronium.Conclusions. During inhalation induction with 8% sevoflurane in 60% nitrous oxide, rocuronium 0.29 mg kg(-1) (ED95) optimizes intubation conditions for surgery of short duration.