ABSTRACT
The purpose of the study is to optimize the general anesthesia for laparoscopic surgery in children with rokuronium bromide. We investigated the effect of rokuronium on children from 3 to 17 years of age who underwent laparoscopic surgery for up to one hour in the department of anesthesiology and resuscitation of Tushino City Pediatric Hospital. The study included 31 children rated ASA I-II. The children with concomitant liver and kidney dysfunction, cardiovascular, pulmonary, neuromuscular and psychoneurological disorders were excluded from the study group. All patients were divided to three groups. In the group H (n = 9) the induction and maintenance of anesthesia were conducted by halothane, in the group S (n = 9) by sevoflurane and in the group P (n = 13) by propofol. The time of onset of maximum neuromuscular block was 86.8 + 37.6 sec. in group H, 52 + 7.7 in group S and 80.1 + 30.8 in group P accordingly. As we can see, the shortest time with the smallest range of results was in the groups S, which indicates that the most predictable and most rapid onset of neuromuscular block can be reached during the sevoflurane anesthesia. The longest time for the onset of neuromuscular block was in the Halothane group, while the intermediate one was in the propofol group. For the most rapid and comfortable tracheal intubation the optimal combination is rocuronium in a dose of 0.6 mg/kg (2 * ED90) with sevoflurane (52 + 7.7 sec). This method can be applied to case of emergency need for endotracheal intubation. Regardless of the anesthetic, the recovery time of the neuromuscular conduction changes inconsiderably reaching the secure level of TOF? 70% at laparoscopic operations for up to one hour, after which it is possible extubate the patient, which suggests t the predictability of rocuronium.
