Atracurium with halothane and isoflurane in pediatric anesthesia

The study was carried out to assess the effects of atracurium neuromuscular blockade in children anaesthetized with N2O:O2: halothane vs N2O:O2: isoflurane. Thirty-two ASA I-II children, age 1-13 yr, undergoing elective surgery, were divided into two groups according to age and the mode of anaesthesia induction. Anaesthesia was induced in the younger children (group 1: 1-6 yr) with nitrous oxide and inspired halothane or isoflurane in oxygen via a face mask. Intravenous thiopental (6-7 mg/kg-1) was used to induce anaesthesia in older children (group 2: 7-13 yr). Each group of patients was randomly allocated to two groups each receiving halothane (group A: n = 8) or isoflurane (group I: n = 8). Halothane 0.8% end-tidal and isoflurane 1% end-tidal as anaesthesia maintenance. A bolus dose of atracurium 0.35 mg/kg-1 was administered. Premedication consisted of oral flunitrazepam (0.04 mg/kg-1) and bellafoline (0.02 mg/kg-1). Heart rate (by electrocardiography), arterial pressure (by auscultation) were monitored. Then end-expired carbon dioxide concentration was maintained at 30-40 mmHg. Neuromuscular transmission was evaluated by response to indirect stimulation (TOF) of the ulnar nerve at the wrist via surface electrodes. Conditions for endotracheal intubation were excellent in 25 of the children, good in 6 and poor in 1. The intubation was carried out within 112 s (group 1A), 130 s (group 1 I), 112 s (group 2A) and 135 s (group 2 I) following the administration of atracurium. The maximum twitch depression was recorded in the isoflurane groups.(ABSTRACT TRUNCATED AT 250 WORDS)