A short period of inhalation induction with sevoflurane prevents rocuronium-induced withdrawal in children.
BACKGROUND
the aim of this study was to determine whether or not inhalation induction with sevoflurane can prevent the withdrawal movement associated with the injection of rocuronium.


METHODS
a total of 75 pediatric patients were randomly allocated to five groups (S 1.5, 2.0, 2.5, 3.0, and the control group). In the control group (n=15), 2.5% thiopental 5 mg/kg was injected intravenously. Rocuronium 0.4 mg/kg was injected immediately after loss of consciousness. In the S 1.5, 2.0, 2.5, or 3.0 group, rocuronium 0.4 mg/kg was injected at 1.5, 2, 2.5, or 3 min after inhalation induction, respectively, and the withdrawal response was recorded. End-tidal sevoflurane concentrations were recorded at the time of the rocuronium injection. The inhalation time of sevoflurane before rocuronium injection required to provide no withdrawal response in 50% and 95% of patients (IT(50) and IT(95) ) was calculated.


RESULTS
the incidence of withdrawal was 80% (12/15), 71.4% (10/14), 21% (3/14), 0% (0/14), and 0% (0/15) in group C, group S 1.5, group S 2.0, group S 2.5, and group S 3.0, respectively. IT(50) of the rocuronium injection time was 1.7 min (95% CI: 1.5-1.9) and IT(95) was 2.3 min (95% CI: 2.0- 2.9).


CONCLUSIONS
this study demonstrated that inhalation induction with sevoflurane can prevent the withdrawal movement induced by rocuronium in children, and IT(50) and IT(95) for the prevention of movement was 1.7 and 2.3 min, respectively.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Kyeonggi-do, Korea.
S H
SH
Park
A Y
AY
Oh
E K
EK
Goo
F S
FS
Nahm
S W
SW
Min
J W
JW
Hwang
C S
CS
Kim
N R
NR
Shin
J H
JH
Kim
D000732:Androstanols / Q000009:adverse effects*; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D001767:Blinking / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008738:Methyl Ethers; D009068:Movement / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects*; D013508:Ophthalmologic Surgical Procedures; D010146:Pain / Q000139:chemically induced* / Q000517:prevention & control*; D012044:Regression Analysis; D000077123:Rocuronium; D018401:Sample Size; D000077149:Sevoflurane; D013285:Strabismus / Q000601:surgery
D000732:Androstanols; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D003473:Neuromuscular Nondepolarizing Agents; D000077149:Sevoflurane; D000077123:Rocuronium