Effects of promethazine or dexamethasone pretreatment on mivacurium-induced histamine release in children.
OBJECTIVE
To determine the effects of pretreatment with either promethazine or dexamethasone on mivacurium-induced histamine release in children.


METHODS
Eighty ASA I-II children (4-10 years of age) scheduled for tonsillectomy and/or adenoidectomy were randomly divided into 4 groups (n = 20 per group) designated as either the rocuronium, mivacurium, dexamethasone (DXM), or promethazine group. Children in the DXM and promethazine groups were treated separately with intramuscular DXM 0.2 mg·kg(-1) or promethazine 0.5 mg·kg(-1) injections 60 min before operation. Radial artery blood samples were collected to quantify plasma histamine concentrations 1 min before and 1, 3, and 5 min after administration of the relaxant. Mean arterial pressure (MAP), heart rate (HR), and skin flushing were recorded at the same time.


RESULTS
No significant decreases in plasma histamine concentrations were observed between groups; however, more stable MAP and HR and less skin flushing were observed in DXM group participants compared with individuals in the mivacurium group (P < 0.05). By contrast, children in the promethazine group had significantly decreased plasma histamine concentrations and stable MAP and HR (without a significant increase in HR) compared with patients in mivacurium group. In addition, skin flushing was significantly decreased compared with that observed in the rocuronium group (P < 0.05).


CONCLUSIONS
Pretreatment with promethazine significantly decreased mivacurium-induced histamine release in children and provided stable hemodynamics during administration of anesthesia.
Department of Anesthesiology, Wuhan General Hospital of Guangzhou Command, Wuhan, Hubei, China.
Zhou
Z
Xiang
Qu
Q
Yan-Liang
Song
S
Xiao-Yang
Zhang
Z
Yan-Hui
Chen
C
Min
Gan
G
Guo-Shen
Wu
W
Ming-Chun
Luo
L
Zhong-Bing
Wang
W
Qing-Li
Hu
H
Guang-Jun
Qin
Q
Ming-Zhe
Tao
T
Jun
D000233:Adenoidectomy; D000293:Adolescent; D000732:Androstanols / Q000009:adverse effects; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D005712:Galvanic Skin Response / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006632:Histamine / Q000097:blood; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006636:Histamine Release / Q000187:drug effects*; D006801:Humans; D007546:Isoquinolines / Q000009:adverse effects*; D008297:Male; D000077590:Mivacurium; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects*; D011300:Preoperative Care; D011398:Promethazine / Q000627:therapeutic use*; D000077123:Rocuronium; D014068:Tonsillectomy
D000732:Androstanols; D018926:Anti-Allergic Agents; D000893:Anti-Inflammatory Agents; D006634:Histamine H1 Antagonists; D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D003907:Dexamethasone; D006632:Histamine; D011398:Promethazine; D000077123:Rocuronium
children; histamine release; mivacurium; rocuronium; surgery