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- Title
Incidence of residual neuromuscular blockade in children below 3 years after a single bolus of cisatracurium 0.1 mg/kg: A quality assurance study.
- Authors
Vested, Matias; Tarpgaard, Mona; Eriksen, Kirsten; Rasmussen, Lars S.
- Abstract
<bold>Background: </bold>The aim of this quality assurance study was to determine the proportion of patients with residual block (train-of-four (TOF) ratio <0.9) upon conclusion of surgery after a bolus of cisatracurium 0.1 mg/kg. It was considered good quality if less than 10% of the study population had residual block upon conclusion of surgery.<bold>Methods: </bold>A total of 40 patients ≤3 years of age scheduled for cleft lip and palate repair were consecutively enrolled. They received general anaesthesia with either sevoflurane and fentanyl (n = 20) or propofol and remifentanil (n = 20). TOF stimulation using acceleromyography was applied on the tibial nerve. Cisatracurium 0.1 mg/kg was administered to facilitate tracheal intubation.<bold>Results: </bold>Three patients (8%; 95% CI: 1.7-21) had a TOF ratio <0.9 at conclusion of surgery, all three receiving sevoflurane. In the sevoflurane group, this corresponded to 16% (95% CI: 3.3-40) of the patients. Mean duration of action of cisatracurium 0.1 mg/kg was 119 minutes (SD 40) with sevoflurane and 73 minutes (SD 29) during total intravenous anaesthesia (P < .001). Onset time of cisatracurium 0.1 mg/kg was 166 seconds (SD 37) with sevoflurane and 199 seconds (SD 60) during total intravenous anaesthesia.<bold>Conclusion: </bold>We found that 8% of the children had residual neuromuscular blockade (TOF ratio <0.9) after administration of a single bolus of cisatracurium 0.1 mg/kg but we cannot exclude that the true proportion is around 20%.
- Subjects
PALATE surgery; QUALITY assurance; BOLUS drug administration; TIBIAL nerve; CLEFT lip; NEUROMUSCULAR blockade; RESEARCH; TIME; RESEARCH methodology; CLEFT palate; EVALUATION research; MEDICAL cooperation; PATIENT monitoring; COMPARATIVE studies; ATRACURIUM; NEUROMUSCULAR blocking agents; PHARMACODYNAMICS
- Publication
Acta Anaesthesiologica Scandinavica, 2020, Vol 64, Issue 2, p168
- ISSN
0001-5172
- Publication type
journal article
- DOI
10.1111/aas.13495