title: Intubation conditions with low dose rocuronium under sevoflurane induction for children.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Taipei.
authors.forename: Chao-Tsen
authors.initials: CT
authors.lastname: Hung
authors.forename: Ming-Hung
authors.initials: MH
authors.lastname: Shih
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Shih
authors.forename: Shiue-Chin
authors.initials: SC
authors.lastname: Liou
authors.forename: Yi-Chuan
authors.initials: YC
authors.lastname: Kau
authors.forename: Chit
authors.initials: C
authors.lastname: Chan
authors.forename: Kit-Man
authors.initials: KM
authors.lastname: Wong
mesh_terms: 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
chemical_list: D000732:Androstanols; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077123:Rocuronium