Resistance to Neuromuscular Blockade by Rocuronium in Surgical Patients with Spastic Cerebral Palsy
| Autor: | Stephanie K Lee, Freeman Miller, Madison Lodge, Robert E. Akins, Karyn G. Robinson, Mary C. Theroux |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_treatment Medicine (miscellaneous) rocuronium Article Cerebral palsy 03 medical and health sciences 0302 clinical medicine Spastic cerebral palsy medicine Spastic Intubation Rocuronium skeletal muscle Neuromuscular Blockade cerebral palsy drug resistance business.industry Gestational age Gross Motor Function Classification System medicine.disease 030104 developmental biology Anesthesia Medicine business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of Personalized Medicine, Vol 11, Iss 765, p 765 (2021) Journal of Personalized Medicine Volume 11 Issue 8 |
| ISSN: | 2075-4426 |
| Popis: | Individuals with spastic cerebral palsy (CP) often exhibit altered sensitivities to neuromuscular blocking agents (NMBAs) used for surgical intubation. We assessed usage of the NMBA rocuronium in patients with spastic CP and evaluated potential modifiers of dosing including gross motor function classification system (GMFCS) level, birthweight, gestational age, and the use of anticonvulsant therapy. In a case-control study, surgical patients with spastic CP (n = 64) or with idiopathic or non-neuromuscular conditions (n = 73) were enrolled after informed consent/assent. Patient data, GMFCS level, anticonvulsant use, and rocuronium dosing for intubation and post-intubation neuromuscular blockade were obtained from medical records. Findings reveal participants with CP required more rocuronium per body weight for intubation than controls (1.00 ± 0.08 versus 0.64 ± 0.03 mg/kg p < 0.0001). Dosing increased with GMFCS level (Spearman’s rho = 0.323 p = 0.005), and participants with moderate to severe disability (GMFCS III-V) had elevated rocuronium with (1.21 ± 0.13 mg/kg) or without (0.86 ± 0.09 mg/kg) concurrent anticonvulsant therapy. Children born full-term or with birthweight > 2.5 kg in the CP cohort required more rocuronium than preterm and low birthweight counterparts. Individuals with CP exhibited highly varied and significant resistance to neuromuscular blockade with rocuronium that was related to GMFCS and gestational age and weight at birth. |
| Databáze: | OpenAIRE |
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