Tracheal intubating conditions and pharmacodynamics following cisatracurium in infants and children undergoing halothane and thiopental-fentanyl anesthesia

George Meakin, George H. Meakin, Olli A. Meretoja, Russell J. Perkins, Ian Waite, Tomi Taivainen, Kari Wirtavuori, Anthony K. Murphy, Leena Raiha

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background: The aims of the present study were to determine the tracheal intubating conditions, onset time, duration of action, and hemodynamic responses following the administration of cisatracurium 0.15 mg·kg -1 to infants and children. Methods: One hundred and eighty-one infants and children aged 1 month to 12 years were randomized to two groups to receive anesthesia with nitrous oxide-oxygen-halothane (group H) or nitrous oxide-oxygen- thiopental-fentanyl (group TF). Intubation conditions were assessed 120 s after cisatracurium administration using a 4-part scale. Neuromuscular transmission was monitored by recording the evoked compound electromyogram of the adductor pollicis. Results: The proportion of patients with excellent or good intubating conditions was similar in both groups (88 of 90, 98% in group H; 85 of 90, 94% in group TF). However, there was a significantly greater proportion of excellent intubating conditions in group H (79 of 90, 88%) compared with group TF (65 of 90, 72%) (P = 0.01) and recovery time was significantly longer in group H compared with group TF (P <0.001). There was also a higher proportion of excellent intubating conditions in infants compared with older subjects (P = 0.02) and a shorter onset time (P <0.001) and longer recovery time (P <0.001) in younger compared with older patients. Changes in heart rate and arterial pressure were negligible 1 min following the cisatracurium administration. Conclusions: Cisatracurium 0.15 mg·kg -1 produces acceptable intubating conditions at 120 s in the great majority of infants and children. Anesthesia background and age have significant effects on intubating conditions and duration of action of cisatracurium. © 2007 The Authors.
    Original languageEnglish
    Pages (from-to)113-120
    Number of pages7
    JournalPaediatric Anaesthesia
    Volume17
    Issue number2
    DOIs
    Publication statusPublished - Feb 2007

    Keywords

    • Analgesics
    • Anesthesia
    • Anesthetics i.v.
    • Anesthetics inhaled
    • Cisatracurium
    • Fentanyl
    • Halothane
    • Intubation
    • Neuromuscular block
    • Thiopental
    • Tracheal

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