The pharmacodynamics of rocuronium in pediatric patients anesthetized with halothane

George Bikhazi, Flor Marin, Norman James Halliday, Krishnaprasad Deepika, Francis F. Foldes

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The aim of this study was to determine the neuromuscular blocking potency of rocuronium (ORG 9426) in 4-to 14-year old children anesthetized with halothane. After induction of anesthesia, the ulnar nerve was stimulated with electrical impulses of 0.2 ms duration every 12 s and the force of contraction of the thumb (P) was continuously recorded. Doses of 0.12, 0.16, 0.20, and 0.24 mg·kg-1 rocuronium were administered, in a randomized fashion, to 4 groups of 12 patients each. The ED50, ED90, and ED95 of rocuronium determined from the log dose-probit regression lines were 0.18, 0.34, and 0.40 mg·kg-1, respectively. To facilitate tracheal intubation, after the development of the maximal effect of the first dose, a variable second dose of rocuronium was administered to increase the total dose to 0.3 mg·kg-1. If after the second dose P was greater than 10% of control, additional 0.025-0.1 mg·kg-1 increments of rocuronium were administered until P became less than 10% of control. At this time the trachea was intubated. Muscular relaxation was maintained with 0.075, 0.1, or 0.125 mg·kg-1 rocuronium, administered whenever P recovered to 25% of control. The clinical duration of these doses was 6.9±2.8, 6.1±0.4, and 8.1±0.6 min, respectively. On repeated administration of three 0.1 or 0.125 mg·kg-1 doses, rocuronium showed little cumulative tendency. Time for spontaneous recovery of P from 25% to 75%, 8.4±0.39 min and from 10% to 90%, 16.19±0.15 min, of control, were relatively short. When at termination of anesthesia T4/T1 ratios were lower than 0.75, the residual neuromuscular block could be antagonized with 0.5 mg·kg-1 edrophonium in 2 min. Rocuronium, 0.3 mg·kg-1 caused a 13.5% increase of heart rate but had no effect on blood pressure. In conclusion, in 4 to 14-year-old children, rocuronium appears to have a more rapid onset and shorter duration of action than other steroid-type muscle relaxants.

Original languageEnglish
Pages (from-to)256-260
Number of pages5
JournalJournal of Anesthesia
Volume8
Issue number3
DOIs
StatePublished - Sep 1 1994

Fingerprint

Halothane
Pediatrics
Delayed Emergence from Anesthesia
Anesthesia
Edrophonium
rocuronium
Ulnar Nerve
Thumb
Trachea
Intubation
Heart Rate
Steroids
Blood Pressure
Muscles

Keywords

  • Dose-response in children
  • Effect on heart rate in children
  • Neuromuscular blocking drugs
  • Rocuronium

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Bikhazi, G., Marin, F., Halliday, N. J., Deepika, K., & Foldes, F. F. (1994). The pharmacodynamics of rocuronium in pediatric patients anesthetized with halothane. Journal of Anesthesia, 8(3), 256-260. https://doi.org/10.1007/BF02514645

The pharmacodynamics of rocuronium in pediatric patients anesthetized with halothane. / Bikhazi, George; Marin, Flor; Halliday, Norman James; Deepika, Krishnaprasad; Foldes, Francis F.

In: Journal of Anesthesia, Vol. 8, No. 3, 01.09.1994, p. 256-260.

Research output: Contribution to journalArticle

Bikhazi, G, Marin, F, Halliday, NJ, Deepika, K & Foldes, FF 1994, 'The pharmacodynamics of rocuronium in pediatric patients anesthetized with halothane', Journal of Anesthesia, vol. 8, no. 3, pp. 256-260. https://doi.org/10.1007/BF02514645
Bikhazi, George ; Marin, Flor ; Halliday, Norman James ; Deepika, Krishnaprasad ; Foldes, Francis F. / The pharmacodynamics of rocuronium in pediatric patients anesthetized with halothane. In: Journal of Anesthesia. 1994 ; Vol. 8, No. 3. pp. 256-260.
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abstract = "The aim of this study was to determine the neuromuscular blocking potency of rocuronium (ORG 9426) in 4-to 14-year old children anesthetized with halothane. After induction of anesthesia, the ulnar nerve was stimulated with electrical impulses of 0.2 ms duration every 12 s and the force of contraction of the thumb (P) was continuously recorded. Doses of 0.12, 0.16, 0.20, and 0.24 mg·kg-1 rocuronium were administered, in a randomized fashion, to 4 groups of 12 patients each. The ED50, ED90, and ED95 of rocuronium determined from the log dose-probit regression lines were 0.18, 0.34, and 0.40 mg·kg-1, respectively. To facilitate tracheal intubation, after the development of the maximal effect of the first dose, a variable second dose of rocuronium was administered to increase the total dose to 0.3 mg·kg-1. If after the second dose P was greater than 10{\%} of control, additional 0.025-0.1 mg·kg-1 increments of rocuronium were administered until P became less than 10{\%} of control. At this time the trachea was intubated. Muscular relaxation was maintained with 0.075, 0.1, or 0.125 mg·kg-1 rocuronium, administered whenever P recovered to 25{\%} of control. The clinical duration of these doses was 6.9±2.8, 6.1±0.4, and 8.1±0.6 min, respectively. On repeated administration of three 0.1 or 0.125 mg·kg-1 doses, rocuronium showed little cumulative tendency. Time for spontaneous recovery of P from 25{\%} to 75{\%}, 8.4±0.39 min and from 10{\%} to 90{\%}, 16.19±0.15 min, of control, were relatively short. When at termination of anesthesia T4/T1 ratios were lower than 0.75, the residual neuromuscular block could be antagonized with 0.5 mg·kg-1 edrophonium in 2 min. Rocuronium, 0.3 mg·kg-1 caused a 13.5{\%} increase of heart rate but had no effect on blood pressure. In conclusion, in 4 to 14-year-old children, rocuronium appears to have a more rapid onset and shorter duration of action than other steroid-type muscle relaxants.",
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