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End-tidal concentration of sevoflurane for preventing rocuronium-induced withdrawal of the arm in pediatric patients
BACKGROUND: During induction of general anesthesia, the intravenous injection of rocuronium is often associated with withdrawal movement of the arm due to pain, and this abrupt withdrawal may result in dislodgement of the venous catheter, injury, or inadequate injection of rocuronium. We performed t...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Anesthesiologists
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028553/ https://www.ncbi.nlm.nih.gov/pubmed/24851161 http://dx.doi.org/10.4097/kjae.2014.66.4.274 |
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author | Yeom, Jong Hoon Kim, Yong Oh Lee, Jae Min Jeon, Woo Jae |
author_facet | Yeom, Jong Hoon Kim, Yong Oh Lee, Jae Min Jeon, Woo Jae |
author_sort | Yeom, Jong Hoon |
collection | PubMed |
description | BACKGROUND: During induction of general anesthesia, the intravenous injection of rocuronium is often associated with withdrawal movement of the arm due to pain, and this abrupt withdrawal may result in dislodgement of the venous catheter, injury, or inadequate injection of rocuronium. We performed this study to evaluate the 50 and 95% effective end-tidal concentrations of sevoflurane (ET(sev)) for preventing rocuronium-induced withdrawal of the arm. METHODS: We conducted a prospective double-blind study in 31 pediatric patients. After free flow of lactated Ringer's IV fluid was confirmed, anesthesia was induced in the patients by using 2.5% thiopental sodium (4 mg/kg) and sevoflurane (4 vol%) with 6 L/min of oxygen. When the target ETsev was reached, preservative-free 1% lidocaine (1.5 mg/kg) was intravenously injected during manual venous occlusion and rocuronium (0.6 mg/kg) was injected after lidocaine injection under free-flow intravenous fluid. A nurse who was an investigator and was blinded to the ETsev injected the rocuronium. The nurse evaluated the response. RESULTS: Non-withdrawal movement was observed in 5 out of 11 patients with ETsev 3.0 vol% and in 5 out of 6 patients with ETsev 3.5 vol%. By Dixon's up-and-down method, the 50% effective concentration (EC(50)) of sevoflurane for non-withdrawal movement at rocuronium injection was 3.1 ± 0.4 vol%. A logistic regression curve of the probability of non-withdrawal movements showed that the 50% effective ET(sev) for abolishing withdrawal movement at rocuronium injection was 2.9 vol% (95% confidence interval [CI] 2.4-3.8 vol%) and the 95% effective ET(sev) was 4.3 vol% (95% CI 3.6-9.8 vol%). CONCLUSIONS: This study showed that the 50 and 95% effective ETsev that prevent withdrawal movement at rocuronium injection are 2.9 and 4.3 vol%, respectively. |
format | Online Article Text |
id | pubmed-4028553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | The Korean Society of Anesthesiologists |
record_format | MEDLINE/PubMed |
spelling | pubmed-40285532014-05-21 End-tidal concentration of sevoflurane for preventing rocuronium-induced withdrawal of the arm in pediatric patients Yeom, Jong Hoon Kim, Yong Oh Lee, Jae Min Jeon, Woo Jae Korean J Anesthesiol Clinical Research Article BACKGROUND: During induction of general anesthesia, the intravenous injection of rocuronium is often associated with withdrawal movement of the arm due to pain, and this abrupt withdrawal may result in dislodgement of the venous catheter, injury, or inadequate injection of rocuronium. We performed this study to evaluate the 50 and 95% effective end-tidal concentrations of sevoflurane (ET(sev)) for preventing rocuronium-induced withdrawal of the arm. METHODS: We conducted a prospective double-blind study in 31 pediatric patients. After free flow of lactated Ringer's IV fluid was confirmed, anesthesia was induced in the patients by using 2.5% thiopental sodium (4 mg/kg) and sevoflurane (4 vol%) with 6 L/min of oxygen. When the target ETsev was reached, preservative-free 1% lidocaine (1.5 mg/kg) was intravenously injected during manual venous occlusion and rocuronium (0.6 mg/kg) was injected after lidocaine injection under free-flow intravenous fluid. A nurse who was an investigator and was blinded to the ETsev injected the rocuronium. The nurse evaluated the response. RESULTS: Non-withdrawal movement was observed in 5 out of 11 patients with ETsev 3.0 vol% and in 5 out of 6 patients with ETsev 3.5 vol%. By Dixon's up-and-down method, the 50% effective concentration (EC(50)) of sevoflurane for non-withdrawal movement at rocuronium injection was 3.1 ± 0.4 vol%. A logistic regression curve of the probability of non-withdrawal movements showed that the 50% effective ET(sev) for abolishing withdrawal movement at rocuronium injection was 2.9 vol% (95% confidence interval [CI] 2.4-3.8 vol%) and the 95% effective ET(sev) was 4.3 vol% (95% CI 3.6-9.8 vol%). CONCLUSIONS: This study showed that the 50 and 95% effective ETsev that prevent withdrawal movement at rocuronium injection are 2.9 and 4.3 vol%, respectively. The Korean Society of Anesthesiologists 2014-04 2014-04-28 /pmc/articles/PMC4028553/ /pubmed/24851161 http://dx.doi.org/10.4097/kjae.2014.66.4.274 Text en Copyright © the Korean Society of Anesthesiologists, 2014 http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Research Article Yeom, Jong Hoon Kim, Yong Oh Lee, Jae Min Jeon, Woo Jae End-tidal concentration of sevoflurane for preventing rocuronium-induced withdrawal of the arm in pediatric patients |
title | End-tidal concentration of sevoflurane for preventing rocuronium-induced withdrawal of the arm in pediatric patients |
title_full | End-tidal concentration of sevoflurane for preventing rocuronium-induced withdrawal of the arm in pediatric patients |
title_fullStr | End-tidal concentration of sevoflurane for preventing rocuronium-induced withdrawal of the arm in pediatric patients |
title_full_unstemmed | End-tidal concentration of sevoflurane for preventing rocuronium-induced withdrawal of the arm in pediatric patients |
title_short | End-tidal concentration of sevoflurane for preventing rocuronium-induced withdrawal of the arm in pediatric patients |
title_sort | end-tidal concentration of sevoflurane for preventing rocuronium-induced withdrawal of the arm in pediatric patients |
topic | Clinical Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028553/ https://www.ncbi.nlm.nih.gov/pubmed/24851161 http://dx.doi.org/10.4097/kjae.2014.66.4.274 |
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