[Comparative study of vecuronium and atracurium at low doses in minor pediatric surgery under combined anesthesia].
To compare, the time of onset and time of recovery of muscular blockade after use of half doses of vecuronium and atracurium, we studied 18 children ASA I who were proposed for short lasting pediatric surgery and combined anesthesia. Patients were divided into two groups: group V (n = 10) was treated with a single dose of 0.05 mg/kg of vecuronium and group A (n = 8) with 0.25 mg/kg of atracurium. Assessment of muscular relaxation was performed by measuring the electromyographic responses to a train of four stimuli applied to the cubital nerve at the level of the hypothenar eminence. We administered 0.02 mg/kg of atropine, 5 to 10 mg/kg of thiopental, and the muscular relaxing dose together with orotracheal intubation when the first stimulus of the train of four stimuli was blocked at 90% of its initial value (T90). Maintenance of the anesthetic level was performed with 50% of N2O-O2 without inhalational anesthetics. A caudal blockade was induced by 1 ml/kg of bupivacaine at 0.25%. We measured the following parameters of muscular relaxation: T90, T10 (time at which the 10% of the first stimulus reappears), T25 (time of clinical efficacy) and IR (index of recovery). Only 60% of patients (6 out of the 10 patients of vecuronium group and 5 out of the 8 subjects of atracurium group) achieved the T90. This occurred 2.5 +/- 0.7 min after vecuronium and 3.2 +/- 0.6 min after atracurium. T10 was 13.7 +/- 4.1 min for vecuronium and 13.3 +/- 4.1 min from atracurium. T25 occurred 18.2 +/- 6.5 min after vecuronium and 19.4 +/- 2.1 min for atracurium.(ABSTRACT TRUNCATED AT 250 WORDS)
Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona.
D
D
Blanco
P
P
Alloza
A
A
Montes
M
M
Ortiz
P
P
López
F
F
Vidal
D000763:Anesthesia, Caudal; D000768:Anesthesia, General; D001279:Atracurium / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D008297:Male; D009126:Muscle Relaxation / Q000187:drug effects; D014673:Vecuronium Bromide / Q000008:administration & dosage*
D001279:Atracurium; D014673:Vecuronium Bromide
Estudio comparativo de vecuronio y atracurio a bajas dosis en cirugía pediátrica menor con anestesia combinada.