Intubation conditions with low dose rocuronium under sevoflurane induction for children.
BACKGROUND
During short surgical procedures and when there is a need to avoid the use of anticholinesterase at the end of surgery, the use of a smaller intubation dose of neuromuscular blocking drug is preferred. The aim of this study was to evaluate tracheal intubation conditions using smaller doses of rocuronium for children under sevoflurane induction.


METHODS
Eighty American Society of Anesthesiologists classification physical status I or II children were enrolled. After mask induction with sevoflurane with nitrous oxide for 3 minutes, 0.3 mg/kg of rocuronium was given. Intubation was performed 60 or 90 seconds thereafter. Study group A included children aged 1 to 3 years and 90 seconds between rocuronium injection and intubation. Group B included children aged 1 to 3 years who had 60 seconds between rocuronium injection and intubation. Group C included children aged 4 to 6 years who had 90 seconds between rocuronium injection and intubation. Group D included children aged 4 to 6 years who had 60 seconds between rocuronium injection and intubation. Intubation conditions were judged based on the scoring of ease of jaw opening and laryngoscopy, position of the vocal cords, and degree of straining after tracheal intubation.


RESULTS
All 80 children underwent successful tracheal intubation without laryngospasm or any complications. Intubation conditions were judged as optimal in all children in group A, 95% in group B, 80% in group C, and 65% in group D.


CONCLUSIONS
A total of 0.3 mg/kg of rocuronium was sufficient for tracheal intubation for children 1 to 6 years old under sevoflurane induction. To guarantee optimal intubation conditions for elder children, allow 90 seconds waiting time after rocuronium administration was recommended.
Hung
Chao-Tsen
CT
Department of Anesthesiology, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Taipei.
Shih
Ming-Hung
MH
Shih
Chih-Jen
CJ
Liou
Shiue-Chin
SC
Kau
Yi-Chuan
YC
Chan
Chit
C
Wong
Kit-Man
KM
D000732:Androstanols / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D008738:Methyl Ethers / Q000494:pharmacology*; D000077123:Rocuronium; D000077149:Sevoflurane
D000732:Androstanols; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077123:Rocuronium