Division of Neonatology, Department of Pediatrics, Loyola University Medical Center, Maywood, IL, USA.
J Perinatol. 2011 Jan;31(1):38-43. doi: 10.1038/jp.2010.74. Epub 2010 Jun 10.
The aim of this study was to analyze clinical characteristics of rocuronium as premedication for nonemergent intubation in infants.
Preterm infants requiring nonemergent intubation were randomized to receive atropine and fentanyl with or without rocuronium. Outcomes, patient characteristics and intubator's experience were noted. Onset, duration and degree of clinical paralysis were recorded for rocuronium group and for older infants receiving rocuronium per unit protocol.
Forty-four intubations were randomized (20 rocuronium, 24 control). Groups were similar in chronological and corrected gestational age, weight and intubator's experience. Successful intubation on first attempt was achieved in 35% of intubations under rocuronium vs 8% of controls; rocuronium was the only significant variable by logistic regression (odds ratio=0.052, P=0.029). Complete paralysis was reported in 80% of 57 rocuronium intubations; onset ranged from 14 to 178 s (65.9±43.4), and duration from 1 to 60 min (16.3±13.5).
Rocuronium facilitated successful intubation and provided clinical paralysis quickly in most infants.
本研究旨在分析罗库溴铵作为非紧急插管婴儿术前用药的临床特点。
需要非紧急插管的早产儿被随机分为阿托品和芬太尼加或不加罗库溴铵组。记录结果、患者特征和插管者的经验。记录罗库溴铵组和按单位方案接受罗库溴铵的较大婴儿的罗库溴铵起效时间、持续时间和临床麻痹程度。
44 例插管随机分组（20 例罗库溴铵，24 例对照组）。两组在胎龄、体重和插管者经验方面的时间和矫正时间相似。在罗库溴铵组，首次尝试成功插管的比例为 35%，而对照组为 8%；罗库溴铵是唯一通过逻辑回归有统计学意义的变量（比值比=0.052，P=0.029）。57 例罗库溴铵插管中有 80%报告完全麻痹；起效时间为 14 至 178 秒（65.9±43.4），持续时间为 1 至 60 分钟（16.3±13.5）。
罗库溴铵可促进插管成功，并在大多数婴儿中迅速提供临床麻痹。
