Faculty Collaboration Database

Use of rapacuronium in a child with spinal muscular atrophy. Paediatr Anaesth 2001 Nov;11(6):725-8

Date

11/07/2001

Pubmed ID

11696151

DOI

10.1046/j.1460-9592.2001.00732.x

Scopus ID

2-s2.0-0034756344 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

We report the case of an 18-month-old girl with spinal muscular atrophy (SMA) that received 1 mg x kg(-1) rapacuronium for laryngospasm during induction of anaesthesia. Within 15 min, we observed some diaphragmatic recovery and, after emergence from anaesthesia, the child demonstrated adequate respiratory efforts. However, the child showed diminished strength of the upper extremity muscles. Since the preoperative workup had revealed bulbar symptoms and laryngeal function could not be easily assessed, the patient was kept intubated until upper extremity strength had returned to preoperative levels. Small doses of midazolam had been given to reduce the patient's anxiety but the patient was extubated within 5 h without any complications. Train of four (TOF) monitoring of the right adductor pollicis muscle, performed during anaesthetic recovery, was equivocal. In SMA, muscle groups are differentially affected so that TOF responses may be inconclusive and not reflect the state of the upper airway muscles. To our knowledge, this is the first report of use of a nondepolarizing neuromuscular blocking agent in a child with SMA.

Author List

Stucke AG, Stuth EA

Authors

Astrid G. Stucke MD Professor in the Anesthesiology department at Medical College of Wisconsin
Eckehard A. Stuth MD Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anesthesia, Inhalation
Female
Humans
Infant
Jejunostomy
Laryngismus
Muscular Atrophy, Spinal
Neuromuscular Nondepolarizing Agents
Postoperative Period
Respiratory Function Tests
Vecuronium Bromide