The pharmacodynamics of 2×the effective dose to produce 95% twitch depression of cisatracurium administrated by priming technique in children

Objective To observe the effect of 2×the effective dose to produce 95% twitch depression(ED95) of cisatracurium administrated by priming technique on pharmacodynamics and intubating conditions in children. Methods A total of 39 children,aged from 2 to 10 years old,American Society of Anesthesiologists(ASA) grade Ⅰ or Ⅱ,scheduled for elective operation,were randomly divided into 3 groups(n=13).The patients received a single bolus of cisatracurium 100 μg/kg,priming 10 μg/kg and then 90 μg/kg 5 minutes later,or a single bolus 150 μg/kg in groups D,Y and S,respectively.Anesthesia was induced with midazolam 0.1 mg/kg,fentanyl 2 μg/kg,propofol 2-4 mg/kg and corresponding dose of cisatracurium.Neuromuscular block was assessed by monitoring the electromyographic response of the adductor pollicis to supramaximal train-of-four(TOF) stimulation.The onset time(time from administration to maximal depression of the first twitch response ),duration of peak effect(time from administration to 5% recovery of T1),duration of clinical effect(time from administration to 25% recovery of T1),duration of total effect(time from administration to 95% recovery of T1),recovery index(recovery of T1 from 25% to 75%) and changes of TOF in priming period were recorded. Results There were no significant differences among groups in age,gender,body weight and intubation conditions(P0.05).TOF was not changed in priming period in group Y.The onset time in group S was significantly shorter than that in groups D and Y(P0.05) and the durations of peak,clinical and total effects in group S were significantly longer than those in groups D and Y(P0.05),but the differences between groups D and Y had no statistical significance(P0.05).There was no difference in recovery index among groups(P0.05). Conclusion There is no obvious advantage in pediatric anesthesia of priming 10 μg/kg and then 90 μg/kg cisatracurium.