INTUBATING CONDITIONS AND TIME-COURSE OF ROCURONIUM-INDUCED NEUROMUSCULAR BLOCK IN CHILDREN

We have investigated the potential of rocuronium 0.6 mg kg(-1) (2 x ED (95)) and 0.9 mg kg(-1) (3 x ED(95)) for rapid sequence induction in 1 00 children, aged 3-7 yr. Intubating conditions with the two different doses of rocuronium were assessed in 70 children (n = 35 in each grou p) undergoing elective surgery. Intubation was carried out by mimickin g rapid sequence induction, and intubation conditions were evaluated a ccording to a standard score. Intubating conditions were good to excel lent in all 70 patients investigated (2 x ED(95): excellent 29, good 6 ; 3 x ED(95): excellent 33, good 2). In another 30 children (n = 15 in each group), we examined the times of rocuronium-induced neuromuscula r block using electromyography. Lag time and recovery index did not di ffer significantly between the two groups (lag time: 37 (SD 12) vs 33 (14) s; recovery index: 9 (3) vs 10 (4) min). Three times the ED(95) i nduced deeper neuromuscular block, 1 min after injection compared with 2 x ED(95) (twitch height: 42 (24) vs 25 (19)%, respectively; P < 0.0 5). The same was true for onset time (193 (47) vs 118 (23) s; P < 0.01 ), clinical duration (21 (4) vs 34 (11) min; P < 0.01) and duration to 75% recovery (30 (6) vs 44 (4) min; P < 0.01). By mimicking rapid seq uence induction, both doses of rocuronium offered clinically acceptabl e (good or excellent) intubating conditions.