Optimal dose of rocuronium bromide undergoing adenotonsillectomy under 5% sevoflurane with fentanyl

Hyub Huh, Jeong Jun Park, Ji Yeong Kim, Tae-Hoon Kim, Seung-Zhoo Yoon, Hye Won Shin, Hye Won Lee, Hae Ja Lim, Jang-Eun Cho

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1 Citation (Scopus)

Abstract

Objective Adenotonsillectomy is a short surgical procedure under general anaesthesia in children. An ideal muscle relaxant for adenotonsillectomy would create an intense neuromuscular block while having a quick recovery time without postoperative morbidity. We compared the effect of different doses of rocuronium for the tracheal intubation in children under 5% sevoflurane and fentanyl. Materials and methods 75 children (aged 3–10 years, ASA I) scheduled for adenotonsillectomy were enrolled. Anaesthesia was induced with propofol 2.5 mg/kg, followed by fentanyl 2 μg/kg. After mask ventilation with 5 vol% sevoflurane in 100% oxygen for 2 min, 2 ml of study drug was administered intravenously, i.e., either normal saline (S Group) or one of two doses (0.15 or 0.3 mg/kg) of rocuronium. We assessed conditions during tracheal intubation and also recorded the surgical condition, the time from discontinuation of sevoflurane to extubation and PAED scale, pain scores in PACU. Results Rocuronium groups (96% and 100%, respectively; P < 0.01) showed statistically superior clinically acceptable intubating conditions than the saline group (72%). The 0.3 mg/kg rocuronium (80%) treatment clearly resulted in excellent intubating conditions compared with the 0.15 mg/kg group (44%; p = 0.028). There was no significant difference in the time to extubation and surgical condition, and in the postoperative measures of emergence delirium, pain, and recovery time among the three groups. Conclusion A dose of 0.3 mg/kg rocuronium may provide optimal intubating conditions without delayed recovery in 5% sevoflurane anaesthesia with fentanyl in children undergoing adenotonsillectomy. Clinical trials registry number NCT02467595.

Original languageEnglish
Pages (from-to)70-74
Number of pages5
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume101
DOIs
Publication statusPublished - 2017 Oct 1

Fingerprint

Fentanyl
Intubation
Anesthesia
Pain
Neuromuscular Blockade
Propofol
Masks
General Anesthesia
Registries
sevoflurane
rocuronium
Clinical Trials
Oxygen
Morbidity
Muscles
Pharmaceutical Preparations

Keywords

  • Adenotonsillectomy
  • Children
  • Intubation
  • Recovery
  • Rocuronium

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology

Cite this

@article{572de83ae30b4fad9856972f234071d4,
title = "Optimal dose of rocuronium bromide undergoing adenotonsillectomy under 5{\%} sevoflurane with fentanyl",
abstract = "Objective Adenotonsillectomy is a short surgical procedure under general anaesthesia in children. An ideal muscle relaxant for adenotonsillectomy would create an intense neuromuscular block while having a quick recovery time without postoperative morbidity. We compared the effect of different doses of rocuronium for the tracheal intubation in children under 5{\%} sevoflurane and fentanyl. Materials and methods 75 children (aged 3–10 years, ASA I) scheduled for adenotonsillectomy were enrolled. Anaesthesia was induced with propofol 2.5 mg/kg, followed by fentanyl 2 μg/kg. After mask ventilation with 5 vol{\%} sevoflurane in 100{\%} oxygen for 2 min, 2 ml of study drug was administered intravenously, i.e., either normal saline (S Group) or one of two doses (0.15 or 0.3 mg/kg) of rocuronium. We assessed conditions during tracheal intubation and also recorded the surgical condition, the time from discontinuation of sevoflurane to extubation and PAED scale, pain scores in PACU. Results Rocuronium groups (96{\%} and 100{\%}, respectively; P < 0.01) showed statistically superior clinically acceptable intubating conditions than the saline group (72{\%}). The 0.3 mg/kg rocuronium (80{\%}) treatment clearly resulted in excellent intubating conditions compared with the 0.15 mg/kg group (44{\%}; p = 0.028). There was no significant difference in the time to extubation and surgical condition, and in the postoperative measures of emergence delirium, pain, and recovery time among the three groups. Conclusion A dose of 0.3 mg/kg rocuronium may provide optimal intubating conditions without delayed recovery in 5{\%} sevoflurane anaesthesia with fentanyl in children undergoing adenotonsillectomy. Clinical trials registry number NCT02467595.",
keywords = "Adenotonsillectomy, Children, Intubation, Recovery, Rocuronium",
author = "Hyub Huh and Park, {Jeong Jun} and Kim, {Ji Yeong} and Tae-Hoon Kim and Seung-Zhoo Yoon and Shin, {Hye Won} and Lee, {Hye Won} and Lim, {Hae Ja} and Jang-Eun Cho",
year = "2017",
month = "10",
day = "1",
doi = "10.1016/j.ijporl.2017.07.030",
language = "English",
volume = "101",
pages = "70--74",
journal = "International Journal of Pediatric Otorhinolaryngology",
issn = "0165-5876",
publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - Optimal dose of rocuronium bromide undergoing adenotonsillectomy under 5% sevoflurane with fentanyl

AU - Huh, Hyub

AU - Park, Jeong Jun

AU - Kim, Ji Yeong

AU - Kim, Tae-Hoon

AU - Yoon, Seung-Zhoo

AU - Shin, Hye Won

AU - Lee, Hye Won

AU - Lim, Hae Ja

AU - Cho, Jang-Eun

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Objective Adenotonsillectomy is a short surgical procedure under general anaesthesia in children. An ideal muscle relaxant for adenotonsillectomy would create an intense neuromuscular block while having a quick recovery time without postoperative morbidity. We compared the effect of different doses of rocuronium for the tracheal intubation in children under 5% sevoflurane and fentanyl. Materials and methods 75 children (aged 3–10 years, ASA I) scheduled for adenotonsillectomy were enrolled. Anaesthesia was induced with propofol 2.5 mg/kg, followed by fentanyl 2 μg/kg. After mask ventilation with 5 vol% sevoflurane in 100% oxygen for 2 min, 2 ml of study drug was administered intravenously, i.e., either normal saline (S Group) or one of two doses (0.15 or 0.3 mg/kg) of rocuronium. We assessed conditions during tracheal intubation and also recorded the surgical condition, the time from discontinuation of sevoflurane to extubation and PAED scale, pain scores in PACU. Results Rocuronium groups (96% and 100%, respectively; P < 0.01) showed statistically superior clinically acceptable intubating conditions than the saline group (72%). The 0.3 mg/kg rocuronium (80%) treatment clearly resulted in excellent intubating conditions compared with the 0.15 mg/kg group (44%; p = 0.028). There was no significant difference in the time to extubation and surgical condition, and in the postoperative measures of emergence delirium, pain, and recovery time among the three groups. Conclusion A dose of 0.3 mg/kg rocuronium may provide optimal intubating conditions without delayed recovery in 5% sevoflurane anaesthesia with fentanyl in children undergoing adenotonsillectomy. Clinical trials registry number NCT02467595.

AB - Objective Adenotonsillectomy is a short surgical procedure under general anaesthesia in children. An ideal muscle relaxant for adenotonsillectomy would create an intense neuromuscular block while having a quick recovery time without postoperative morbidity. We compared the effect of different doses of rocuronium for the tracheal intubation in children under 5% sevoflurane and fentanyl. Materials and methods 75 children (aged 3–10 years, ASA I) scheduled for adenotonsillectomy were enrolled. Anaesthesia was induced with propofol 2.5 mg/kg, followed by fentanyl 2 μg/kg. After mask ventilation with 5 vol% sevoflurane in 100% oxygen for 2 min, 2 ml of study drug was administered intravenously, i.e., either normal saline (S Group) or one of two doses (0.15 or 0.3 mg/kg) of rocuronium. We assessed conditions during tracheal intubation and also recorded the surgical condition, the time from discontinuation of sevoflurane to extubation and PAED scale, pain scores in PACU. Results Rocuronium groups (96% and 100%, respectively; P < 0.01) showed statistically superior clinically acceptable intubating conditions than the saline group (72%). The 0.3 mg/kg rocuronium (80%) treatment clearly resulted in excellent intubating conditions compared with the 0.15 mg/kg group (44%; p = 0.028). There was no significant difference in the time to extubation and surgical condition, and in the postoperative measures of emergence delirium, pain, and recovery time among the three groups. Conclusion A dose of 0.3 mg/kg rocuronium may provide optimal intubating conditions without delayed recovery in 5% sevoflurane anaesthesia with fentanyl in children undergoing adenotonsillectomy. Clinical trials registry number NCT02467595.

KW - Adenotonsillectomy

KW - Children

KW - Intubation

KW - Recovery

KW - Rocuronium

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