Related Experiment Video
Updated: Jun 2, 2026
Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review
Published on: March 27, 2026
[Myoplegia during laparascopic surgeries in children]
Insights
Sevoflurane anesthesia combined with rocuronium bromide offers the fastest and most predictable neuromuscular block for pediatric laparoscopic surgery, ensuring rapid tracheal intubation. Recovery times are consistent across anesthetics, highlighting rocuronium
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Optimizing general anesthesia in pediatric patients is crucial for successful laparoscopic surgery.
- Rocuronium bromide is a commonly used neuromuscular blocking agent.
- The choice of inhalation anesthetic can influence the onset and recovery of neuromuscular blockade.
Purpose of the Study:
- To optimize general anesthesia for pediatric laparoscopic surgery using rocuronium bromide.
- To compare the onset of neuromuscular block induced by rocuronium bromide when combined with halothane, sevoflurane, or propofol.
Main Methods:
- A study involving 31 pediatric patients (3-17 years) undergoing laparoscopic surgery.
- Patients were divided into three groups receiving anesthesia with halothane, sevoflurane, or propofol.
- The time to maximum neuromuscular block onset was measured for rocuronium bromide administration.
Main Results:
- The shortest onset time for neuromuscular block was observed with sevoflurane (52 ± 7.7 sec).
- Halothane showed the longest onset time (86.8 ± 37.6 sec), with propofol in between (80.1 ± 30.8 sec).
- Rocuronium bromide at 0.6 mg/kg with sevoflurane provided rapid and predictable tracheal intubation.
Conclusions:
- Sevoflurane anesthesia combined with rocuronium bromide (0.6 mg/kg) is optimal for rapid and predictable neuromuscular block in pediatric laparoscopic surgery.
- This combination facilitates efficient tracheal intubation, even in emergency situations.
- Neuromuscular recovery is predictable and allows for safe extubation regardless of the anesthetic used.
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.
