Neuromuscular recovery following rocuronium bromide single dose in infants

Hj, Rapp; Ca, Altenmueller; Waschke, C.

doi:10.1046/j.1460-9592.2003.01216.x

Cited by 54 publications

(27 citation statements)

References 19 publications

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“…Using the rocuronium dose of 0.5 mg kg À1 in our study, we found the duration of rocuronium to be much shorter (judged by gross motor movements); this difference is likely due to prolongation of duration of rocuronium by inhaled anesthetic agents in the aforementioned studies. 13 Prospective studies by Roberts et al 10 and Dempsey et al 11 showed successful facilitation of endotracheal intubation in neonatal populations similar to ours using mivacurium. Roberts et al 10 showed higher success rates for intubations by the second attempt, shorter duration of intubation procedure and decreased periods of desaturations.…”

Section: Drug Of Choicesupporting

confidence: 75%

“…Several studies provide information on the drug in older pediatric populations. Driessen et al 12 and Rapp et al 13 examined duration of muscle relaxation by observing train-of-four muscle twitches in infants 0 to 12 months using varying doses of rocuronium in conjunction with inhaled anesthetics. Both studies reported effects lasting 46 to 100 min on average; in general, the duration of action was shorter after lower doses (0.3 and 0.45 mg kg À1 ) vs 0.6 mg kg À1 .…”

Section: Drug Of Choicementioning

confidence: 99%

“…Two recent investigations report using mivacurium to safely and effectively facilitate nonemergent intubations in neonates; 10,11 unfortunately, this drug has since been discontinued. Rocuronium bromide (rocuronium) is another short-acting nondepolarizing agent that has been studied in older infant and pediatric populations, 12,13 but has not, to our knowledge, been studied in neonates for nonemergent intubation in the neonatal ICU (NICU).…”

Section: Introductionmentioning

confidence: 99%

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Rocuronium for nonemergent intubation of term and preterm infants

et al. 2010

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Objective: The aim of this study was to analyze clinical characteristics of rocuronium as premedication for nonemergent intubation in infants.Study Design: Preterm infants requiring nonemergent intubation were randomized to receive atropine and fentanyl with or without rocuronium. Outcomes, patient characteristics and intubator's experience were noted. Onset, duration and degree of clinical paralysis were recorded for rocuronium group and for older infants receiving rocuronium per unit protocol.Result: Forty-four intubations were randomized (20 rocuronium, 24 control). Groups were similar in chronological and corrected gestational age, weight and intubator's experience. Successful intubation on first attempt was achieved in 35% of intubations under rocuronium vs 8% of controls; rocuronium was the only significant variable by logistic regression (odds ratio ¼ 0.052, P ¼ 0.029). Complete paralysis was reported in 80% of 57 rocuronium intubations; onset ranged from 14 to 178 s (65.9±43.4), and duration from 1 to 60 min (16.3 ± 13.5).Conclusion: Rocuronium facilitated successful intubation and provided clinical paralysis quickly in most infants.

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Section: Drug Of Choicesupporting

confidence: 75%

Section: Drug Of Choicementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rocuronium for nonemergent intubation of term and preterm infants

et al. 2010

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“…13 Tracheal intubation is generally performed 90 s after rocuronium (0.3 mg/kg) administration and 60 s after succinylcholine (1.5 mg/ kg) administration. General anesthesia with rocuronium (0.45 mg/kg) in infants revealed good results such as effect time, satisfaction of intubation, and time of restoration, 14,15 and was suitable for short operation. 16 The achieved tracheal intubation time observed in our study was 90-120 s without applying topical lidocaine on the pharynx.…”

mentioning

confidence: 98%

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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“…The optimal dose of rocuronium for RSI in neonates has not been determined. Published studies indicate fairly rapid onset times with 0.45 and 0.6 mg/kg IV rocuronium, although these doses were studied in the presence of inhalational anesthetics [ 167 ]. The downside to using such large doses of rocuronium in neonates is the time to recover: 62 and 95 min, respectively [ 121 , 167 ].…”

Section: Anesthetic Agents For Rsimentioning

confidence: 99%