The Influence Of Sevoflurane In Various Duration On Recovery From Neuromuscular Block Following A Single Bolus Dose Of Cisatracurium In Children

Objective To study the effects of 1 MAC sevoflurane of different durations on the recovery from neuromuscular block following a single bolus dose of cisatracurium in children.Mthods 60 children(2⁸yr, ASAâ… ^â…¡) undergoing elective surgery were randomly divided into 3 groups, (20 children each), according to difference, duration of inhalation of sevoflurane: 30-min sevoflurane(group S₃₀), 60-min sevoflurane(group S₆₀), or total intravenous anesthesia((i.e. no sevoflurane, group T). Anesthesia was induced with midazolam, propofol and sufentanyl, a single bolus dose of cisatracurium (3ED₉₅, 0.15mg·kg^-1). Anesthesia was maintained with remifentanil and propofol in all groups, meanwhile, Group S₃₀ and S₆₀ children were exposed to 1 MAC sevoflurane after tracheal intubation. Neuromuscular block was assessed with TOF-Watch SX accelerometry. Onset time, duration of peak effect, recovery index, duration of clinical action, duration of total action and time to TOFR(T₄/T₁) 70% were recorded. Results There was no significant difference in onset time among the three groups(P>0.05). Duration of peak effect, duration of clinical action, duration of total action and TOFR_0.7 were significantly prolonged with increasing durations of sevoflurane inhalation (P<0.05). Recovery index of Group S₆₀ was significantly prolonged compared to Group T (P<0.05), while recovery index of Group S₃₀ was not significantly different from Group T and Group S₆₀ (P>0.05).Conclusion The muscle relaxation effect of cisatracurium was potentiated by 1MAC sevoflurane with increasing durations of inhalation in children. 60 min of sevoflurane inhalation may delay the spontaneous recovery from a single bolus dose of cisatracurium, while 30 min or less of sevoflurane may not.