Predicting recovery from deep neuromuscular block by rocuronium in children and adults.
OBJECTIVE
To compare the response to motor nerve stimulation at a rate of 1 Hz after 50 Hz tetanus [posttetanic count (PTC)] and 2 Hz for 2 seconds [train-of-four (TOF)] in children and adults during spontaneous recovery from blockade caused by rocuronium.


METHODS
Prospective, clinical, observational, multicenter study.


METHODS
Operating rooms of two university hospitals.


METHODS
22 children (ASA physical status I and II) aged 2 to 5 years, scheduled to undergo dental treatment and 20 adults aged 18 to 60 years, scheduled to undergo elective general or orthopedic surgery during general anesthesia with tracheal intubation.


METHODS
Neuromuscular blockade was evaluated with accelerometry of the thumb, using PTC and TOF stimulation of the ulnar nerve, in patients who received rocuronium 1 mg x kg(-1).


RESULTS
The first response to posttetanic and TOF nerve stimulation appeared earlier in children than in adults. The time from injection of rocuronium to appearance of the fourth response to TOF ranged from 27 to 62 minutes in children and from 37 to 94 minutes in adults. The average interval between the appearance of a posttetanic response and the first detectable response to TOF stimulation (T1) was also shorter in children, 7 minutes, than in adults, 16 minutes. The relationship between PTC and the time interval between a given PTC and the first detectable TOF response in both children and adults was exponential (R = -0.64 and R = -0.81, respectively).


CONCLUSIONS
Children recover faster than adults from neuromuscular blockade after administration of 1 mg x kg(-1) rocuronium. The relationship between PTC and time to first response to TOF is exponential both in children and adults during recovery from neuromuscular blockade caused by rocuronium.
Baykara
Nur
N
Department of Anesthesiology, School of Medicine, University of Kocaeli, Kocaeli, Turkey. baykaranurq@yahoo.com
Woelfel
Susan
S
Fine
Gavin F
GF
Solak
Mine
M
Toker
Kamil
K
Brandom
Barbara W
BW
D000293:Adolescent; D000328:Adult; D000732:Androstanols / Q000008:administration & dosage*; D000762:Anesthesia Recovery Period; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D000077123:Rocuronium; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium