Abstract:
:Dose-response relationships for the antagonism of intermediate-acting neuromuscular blocking agents have not been evaluated previously in children. We have examined the dose-response relationships for neostigmine antagonism of 90% rocuronium-induced neuromuscular block in children and adults, during nitrous oxide-1 MAC of isoflurane anaesthesia. We studied 40 children, aged 2-10 yr, and 50 adults, aged 18-60 yr; all received a single bolus dose of rocuronium 0.6 mg kg-1 and accelerometry was used to monitor neuromuscular transmission. When the first twitch of the train-of-four (TOF) response (T1) recovered to 10% of its control (T0), one of five doses of neostigmine 0, 5, 10, 20 or 50 micrograms kg-1 was given by random allocation to each of the study groups (n = 8 children and n = 10 adults). Recovery of T1 and TOF ratio (T4/T1%) was recorded for 10 min after initial administration of neostigmine. Onset time of rocuronium-induced block was faster in children than in adults (mean 64.6 (95% confidence intervals 57.7-71.5) s vs 83.7 (70.7-96.6) s; P < 0.05). The time to 10% recovery of T1/T0 was shorter in children than in adults (25.4 (22.9-27.9) min vs 38.8 (36.1-41.4) min; P < 0.001). Spontaneous and antagonist-assisted recovery were more rapid in children than in adults. Adequate recovery (T4/T1 of 80%) occurred in children at 4, 5 and 8 min after neostigmine 50, 20 and 10 micrograms kg-1, respectively. Adequate recovery was not produced in adults by any dose of neostigmine within 10 min. The effective doses of neostigmine required to achieve a TOF ratio of 80% (ED80) after 10 min in children and adults were, respectively, 7.10 (5.2-9.8) micrograms kg-1 and 56.56 (45.5-71.9) micrograms kg-1 (P < 0.001). There was no advantage in administering doses of neostigmine greater than 20 micrograms kg-1 to antagonize 90% rocuronium-induced neuromuscular block in children. In contrast, it appeared prudent to use neostigmine 50 micrograms kg-1 or more for adequate antagonism of a similar degree of block in adults.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Abdulatif M,Mowafi H,al-Ghamdi A,el-Sanabary Mdoi
10.1093/bja/77.6.710subject
Has Abstractpub_date
1996-12-01 00:00:00pages
710-5issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)42030-7journal_volume
77pub_type
临床试验,杂志文章,随机对照试验abstract::Plasma concentrations of amethocaine were measured after topical application of amethocaine cream 2 g (5% w/w) to the dorsum of the right hand of 10 adult volunteers. The cream was applied for 240 min and plasma was assayed for amethocaine and its metabolite p-n-butylaminobenzoic acid at 0, 30, 60, 90, 120 and 240 min...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.4.432
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abstract:BACKGROUND:Arterial cannulation is a common anaesthetic procedure that can be challenging and time-consuming in small children. By visualizing the position of the radial artery, near-infrared vascular imaging systems (NIRVISs) might be of assistance in arterial cannulation. The present study evaluates the effectiveness...
journal_title:British journal of anaesthesia
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doi:10.1093/bja/aes193
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abstract::We have studied the effects of mivacurium after induction of anaesthesia with alfentanil-propofol in healthy adult oral surgical patients. Anaesthesia was maintained with nitrous oxide and 0.75% (end-tidal) enflurane in oxygen after nasotracheal intubation. Recordings were made of the rectified compound adductor polli...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/67.3.289
更新日期:1991-09-01 00:00:00
abstract::In a prospective randomized multi-centre study, the mortality following internal fixation surgery for fracture of the upper femur was investigated in 538 elderly patients allocated to receive subarachnoid blockade or general (narcotic-relaxant) anaesthesia. The 28-day mortality was 6.6% with subarachnoid, and 5.9% wit...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1987-09-01 00:00:00
abstract::For 6 months after renal transplant serum cholinesterase concentrations were measured in 10 patients. The value decreased in the first 15 days after operation, but was normal thereafter. Liver function tests were normal throughout the study; the cholinesterase changes were independent of immunosuppressive therapy. ...
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abstract::The influence of sodium nitroprusside (SNP) on mitochondrial respiration was examined in rat liver mitochondria. The addition of SNP 1 mmol litre-1 during state 3 respiration inhibited the oxygen uptake by 63.4%. A mixture of SNP 1 mmol litre-1 and glutathione (GSH) 1 mmol litre-1 inhibited the oxygen uptake more mark...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
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更新日期:1977-12-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2009-10-01 00:00:00
abstract::Arterial pressure is still one of the most important measures in estimating the required dose of inhaled anaesthetics. It is measured easily and reacts rapidly which makes it suitable as a variable for feedback control of depth of anaesthesia. Fuzzy logic, a novel approach to feedback control, was used to control arte...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1995-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/bja/71.3.447
更新日期:1993-09-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-10-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2012-08-01 00:00:00
abstract::Dysregulation of the immuno-inflammatory response, as seen in sepsis, may culminate in host cell and organ damage. Lipopolysaccharide from Gram-negative bacterial cell walls induces gene activation and subsequent inflammatory mediator expression. Gene activation is regulated by a number of transcription factors at the...
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pub_type: 杂志文章,评审
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更新日期:2003-02-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析,评审
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1988-04-01 00:00:00
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pub_type: 杂志文章
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abstract::Alcuronium 0.16 mg kg-1 was used to provide neuromuscular blockade in patients with chronic renal failure undergoing renal transplantation. Relaxation was found to be adequate for intubation and surgery. There were minimal alterations to cardiovascular variables. The dose required was small, and complete reversal occu...
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pub_type: 杂志文章
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更新日期:1984-11-01 00:00:00
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更新日期:2001-03-01 00:00:00
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更新日期:2000-05-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-05-01 00:00:00