Time course of neuromuscular blockade with rocuronium in children with intracardiac shunts.
OBJECTIVE
To evaluate the time course of neuromuscular blockade after rocuronium in children with intracardiac shunts.


METHODS
Prospective study.


METHODS
University hospital.


METHODS
Consecutive children (n = 52) with intracardiac shunts scheduled for elective cardiac surgery. Participants were allocated to 2 groups according to the direction of the shunt.


METHODS
Rocuronium, 0.6 mg/kg, was administered for muscle relaxation. The ulnar nerve was stimulated at 20-second intervals with a supramaximal 2-Hz train-of-4 stimulation (TOF-Guard nerve stimulator; Biomet International, Odense, Denmark). The onset time to maximal twitch depression and the time to clinical recovery were compared between the 2 groups.


RESULTS
The time to maximal block was significantly faster in children with a right-to-left shunt: 56.8 +/- 5.3 seconds versus 77.1 +/- 6.6 seconds (p = 0.01). There was a tendency to shorter recovery in children with a right-to-left shunt: 42.3 +/- 6.1 minutes versus 55.4 +/- 4.9 minutes (p = NS).


CONCLUSIONS
This study shows a more rapid onset of rocuronium in children with cyanotic congenital heart disease. In these patients, rocuronium is indicated, particularly for rapid airway control.
Gozal
Yaacov
Y
Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, Jerusalem, Israel. gozaly@md2.huji.ac.il
Mints
Bella
B
Drenger
Benjamin
B
D000732:Androstanols; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium; D013997:Time Factors
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium