title: Time course of neuromuscular blockade with rocuronium in children with intracardiac shunts.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, Jerusalem, Israel. gozaly@md2.huji.ac.il
authors.forename: Yaacov
authors.initials: Y
authors.lastname: Gozal
authors.forename: Bella
authors.initials: B
authors.lastname: Mints
authors.forename: Benjamin
authors.initials: B
authors.lastname: Drenger
mesh_terms: 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
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium