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Clinical pharmacology of cisatracurium during nitrous oxide-propofol anesthesia in children

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ShangGuan, WangNing, Lian, QingQuan, Li, Jun and Smith, F. Gao (Fang Gao). (2008) Clinical pharmacology of cisatracurium during nitrous oxide-propofol anesthesia in children. Journal of Clinical Anesthesia, Vol.20 (No.6). pp. 411-414. ISSN 0952-8180

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Official URL: http://dx.doi.org/10.1016/j.jclinane.2008.03.011

Abstract

Study Objective: To describe, in pediatric patients, the effects of three doses of cisatracurium during nitrous oxide-propofol anesthesia and to determine if larger doses result in faster onset time.
Setting: College hospital.

Subjects: 75 ASA physical status I and II children, aged 15 to 60 months, undergoing surgery for hypospadias or undescendent testis.

Interventions: Patients were randomly assigned to one of three groups according to the dose of cisatracurium: Group A = 0.1 mg/kg (two x effective dose), Group B = 0. 15 mg/kg (three x effective dose), and Group C = 0.2 mg/kg (4 x effective dose).

Measurements: Neuromuscular block was assessed with TOF-Guard (Biometer International, Odense, Denmark) accelerometry. Onset time (from cisatracurium injection to maximal depression of time to first twitch), duration of peak effect (time from cisatracurium injection to 5% recovery of time to first twitch), duration of clinical action (time from cisatracurium injection to 25% recovery of time to first twitch), and recovery index (recovery of time to first twitch from 25% to 75%) were recorded.

Main Results: Cisatracurium had no effect on heart rate or blood pressure at any dose. Compared with Group A, onset times in Groups B and C were shorter; and durations of peak effect and clinical action in Groups B and C were longer (P < 0.01) than those in Group A. There was no difference in recovery index among the three groups. There was no difference in onset times between Groups B and C. Compared with Group B, durations of peak effect and clinical action in Group C were longer (P < 0.05 or P < 0.01).

Conclusion: Four times the effective dose of cisatracurium did not significantly shorten onset time beyond that produced with three times the effective dose in young children. (C) 2008 Elsevier Inc. All rights reserved.

Item Type:

Journal Article

Subjects:

R Medicine > RD Surgery
R Medicine > RM Therapeutics. Pharmacology

Divisions:

Faculty of Medicine > Warwick Medical School

Library of Congress Subject Headings (LCSH):

Neuromuscular blocking agents, Clinical pharmacology, Neuromuscular transmission -- Effect of drugs on, Anesthetics -- Physiological effect, Pediatric anesthesia

Journal or Publication Title:

Journal of Clinical Anesthesia

Publisher:

Elsevier Inc.

ISSN:

0952-8180

Official Date:

September 2008

Dates:

Date	Event
September 2008	Published

Volume:

Vol.20

Number:

No.6

Number of Pages:

Page Range:

pp. 411-414

Identification Number:

10.1016/j.jclinane.2008.03.011

Status:

Peer Reviewed

Publication Status:

Published

Access rights to Published version:

Restricted or Subscription Access

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