Muscle Relaxants
Conditions
Keywords
no muscle relaxant, rocuronium, intubation condition, tracheal intubation, operating room time, low-dose rocuronium
Brief summary
This study aimed to compare the effect of no muscle relaxants and reduced-dose rocuronium on the anesthetic induction and emergence with fentanyl in children undergoing adenotonsillectomy.
Detailed description
Adenotonsillectomy in children is a short surgical procedure under general anesthesia. The ideal muscle relaxant requires intense neuromuscular block for optimal surgical work and complete recovery of neuromuscular function immediately after the end of the surgical procedure without postoperative morbidity. Rocuronium is an intermediate acting neuromuscular blockade. Reduced-dose rocuronium has been reported to provide optimal anesthetic induction without delayed recovery. The investigators aimed to compare the effect of no muscle relaxants and reduced-dose rocuronium on the anesthetic induction and emergence with fentanyl in children undergoing adenotonsillectomy. After Institutional Review Board approval and written informed consent from the parents were obtained, 75 children (aged 3 to 10 years, ASA(The American Society of Anesthesia ) I or II) scheduled for adenotonsillectomy were included. Anesthesia was induced with propofol 2.5 mg kg-1 , fentanyl 2 mcg kg-1, and rocuronium 0.15 mg kg-1 (R 0.15 group) or rocuronium 0.3mg kg-1 (R 0.3 group) or saline (S group). After mask ventilation with 5 vol% sevoflurane in 100% oxygen for 2 minutes, tracheal intubation was done. The investigators assessed conditions during tracheal intubation as excellent, good or poor, using five variables; jaw relaxation, vocal cord position, vocal cord movement, coughing, and movement of the limbs. The investigators added rocuronium 0.3 mg kg-1 when there was more than one poor condition. The investigators recorded the time from discontinuation of sevoflurane to time to extubation.
Interventions
DRUGRocuronium bromide 0.15 mg kg-1
Rocuronium bromide 0.15 mg kg-1 was injected at I.V. line to patients (R 0.15 group), as muscle relaxants during anesthesia for adenotonsillectomy.
DRUGRocuronium bromide 0.3 mg kg-1
Rocuronium 0.3 mg kg-1 was injected at I.V. line to patients (R 0.3 group), as muscle relaxants during anesthesia for adenotonsillectomy.
DRUGFentanyl
Fentanyl 2 mcg kg-1 was injected at I.V. line to patients
DRUGPropofol
Propofol 2.5 mg kg-1 was injected at I.V. line to patients
DRUGSevoflurane
After mask ventilation with 5 vol% sevoflurane in 100% oxygen for 2 minutes, tracheal intubation was done.
Sponsors
Korea University Anam Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
3 Years to 10 Years
Healthy volunteers
Yes
Inclusion criteria
* American Society of Anesthesiologist\[ASA\] class 1-2 * scheduled adenotonsillectomy * written informed consent
Exclusion criteria
* allergy of opioids, neuromuscular blocking drugs or other medications used during general anesthesia * known or suspected upper respiratory infection * disorder affecting neuromuscular blockade * suspected difficult tracheal intubation * Developmental Disability * known or suspected psychologic disorder * medication (psychoactive drugs)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Conditions during tracheal intubation | At the time to tracheal intubation, after mask ventilation for 2 minutes | We assessed conditions during tracheal intubation as excellent, good or poor, and additionally using five variables; jaw relaxation, vocal cord position, vocal cord movement, coughing, and movement of the limbs. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| time to extubation | intraoperatve | When surgery is end, we discontinue sevoflurane for maintaining anesthesia. So we check the time of this point until extubation. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Additive rocuronium | intraoperatve | We added rocuronium 0.3 mg kg-1 when there was more than one poor intubating condition. |
Outcome results
None listed