2. Daylan Kockaya P, Ozbagriacik O, Oba S, Kockaya G. COMPARISON OF THE EFFECTS OF ROCURONIUM AND ATRACURIUM ON INTUBATION TIME, INTUBATION CONDITIONS, DURATION OF NEUROMUSCULAR BLOCK AND RECOVERY Annual Congress of the European Society for Paediatric Anaesthesiology Palma de Mallorca, September 22 – 24 2011


Daylan Koçkaya P.

Annual Congress of the European Society for Paediatric Anaesthesiology , Avila, Spain, 22 - 24 September 2011, pp.42-43

  • Publication Type: Conference Paper / Summary Text
  • City: Avila
  • Country: Spain
  • Page Numbers: pp.42-43
  • Kocaeli University Affiliated: Yes

Abstract

Muscle relaxant drugs which enabled muscle relaxation -one of the most important

cornerstones of anesthesia- to be performed routinely in practice of anesthesiology,

become one of the main components of this practice. Muscle relaxants are used in

pediatric anesthesia as well as adult anesthesia to obtain adequate muscle relaxation for

intubation and operation. The aim of this study is to compare the effects of 2 different

muscle relaxants on neuromuscular block, intubation quality and recovery.

Method:

After approval of local ethics committee, 2 randomized groups were constituted with ASA

I, 60 cases aged between 1-􀏳􀀃 􀇇􀄞􀄂􀆌􀆐􀀃 􀇁􀅚􀅽􀀃 􀄂􀄚􀅵􀅝􀆚􀆚􀄞􀄚􀀃 􀆚􀅽􀀃 􀁢􀅝􀆔􀅯􀅝􀀃 􀀜􀆚􀄨􀄂􀅯􀀃 􀀜􀄚􀆵􀄐􀄂􀆚􀅝􀅽􀅶􀀃 􀄂􀅶􀄚􀀃 􀁚􀄞􀆐􀄞􀄂􀆌􀄐􀅚􀀃

Hospital Pediatric Surgery Clinics for elective lower abdominal and urogenital surgery.

Starting with maximal block, the stages of recovery from the effects of muscle relaxant

was examined by TOF follow-up with 12 second intervals. The times to reach maximal

blockade (seconds)(TOF0), 25% (TOF25) and 75% (TOF75) of TOF value after maximal

block were recorded by using TOF Watch SX (Organon Technica) .“SPSS for Windows 13.0”

statistical package program was used to evaluate the data. Comparisons were made by

using Student’s t test and Chi-square test.

Results and Discussion

In our study it was observed that, TOF 0, TOF 25 and TOF 75 times were 87.38 ± 20.93 sec,

24.48 ± 6.41 min, and 38.77 ± 8.24 min, respectively in Rocuronium group, whereas they

were 119.30 ± 23.32 sec, 33.13 ± 4.13 min, and 51.37 ± 1.95 min in Atracurium group.

Rocuronium resulted in statistically significantly shorter times in all TOF values with

respect to atracurium. There were no statistically significant differences between the

groups in terms of operation time, doses of other used drugs, and quality of intubation.

Comparison of drug-induced complications between the groups showed that allergy and

bronchospasm complications were seen in 4 patients of atracurium group whereas the

patients in rocuronium group showed no complications. This difference was statistically

significant. It is aimed to choose the better neuromuscular blocker with rapid action which

leads to sufficient muscle relaxation during operation and also leads to rapid and safe

recovery. These neuromuscular blockers may show different pharmacokinetics and

pharmacodynamics in children with regard to adults. Therefore, additional aim was to

avoid of excess doses and different administrations. Muscle relaxant agents are

distributed in extracellular space and they constitute lower plasma concentrations in

EUROPEAN SOCIETY FOR PAEDIATRIC ANAESTHESIOLOGY 43

Abstracts of poster presentations, Palma de Mallorca 43

children when compared to adults. Therefore, to reach a similar neuromuscular block

level in children, a higher muscle relaxant dose may be needed.(1) It is stated that

neuromuscular blockers lead to a faster recovery period in pediatric patients when

compared to adults. Possible reason of this may be the more rapid distribution of the drug

in affected areas due to higher cardiac output per kilogram of body weight in children.(2)

Conclusions : In this study, we evaluated pediatric outpatients underwent lower

abdominal surgery or urogenital surgery. In our hospital, pediatric surgery operations

especially lower abdominal and urogenital interventions mostly last shorter than 1 hour.

Most of the patients are discharged from hospital in the evening of the operation day.

It is concluded that in short-duration operations of outpatient pediatric surgery

cases such as patients of our study, rocuronium may be used safely due to its short

recovery period, rapid start of action, and lower rate of allergic reaction development.