International Medical Journal, Vol. 24., Iss. 4, 2018, P. 90−94.
COMPARATIVE STUDY OF THE EFFECTIVENESS OF MIDDLE-ACTING MUSCLE RELAXANTS IN SMALL SURGICAL INTERVENTIONS IN CHILDREN
Azerbaijan Medical University, Baku, the Republic of Azerbaijan
Ensuring adequate muscle relaxation with small surgical interventions in children is one of the urgent problems of modern pediatric anesthesiology. In order to comparatively study the effectiveness of the average action of muscle relaxants with small surgical interventions in children, a study was conducted in which 156 patients aged 0 to 16 years took part. All operative interventions were performed under balanced general anesthesia with the use of besilat atracurium, besilat cisatracuria and bromide rocuronium. TOF −− stimulation ("traine of four") monitoring of neuromuscular conduction was carried out using the TOF −− Watch (Organon Ireland) device. A comparative assessment of the neuromuscular block with titrated doses of rocuronium bromide, atracuria besilata and cisatracuria besilate was performed in combination with 1.3 MAC isoflurane (subgroup "+ iso") at the stages of tracheal intubation, maintaining general anesthesia and spontaneous recovery of neuromuscular conduction. The development of neuromuscular blockade with the achievement of 90 % suppression of T1 in children of the older age group with the highest rate occurred in the group with rocuronium bromide. The results of the study allowed to deduce the conclusions that when using isoflurane, a reduction in loading doses of atilate of besylate to 0.4 mg/kg, cisatracuria of besylate to 0.12 mg/kg and rocuronium bromide to 0.45 mg/kg ensure sufficient depth of the neuromuscular block (suppression of T1 from 90 % and above). The time of onset of action in children under the age of one when using isoflurane does not significantly change. And in older children, significant differences were obtained only when comparing rocuronium bromide at doses of 0.45 mg/kg and 0.6 mg/kg (p < 0.05).
Key words: medium−effect muscle relaxants, surgical treatment, children, neuromuscular block.