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[Effect of induction methods of pediatric anesthesia on serum myoglobin]
N Sekino1, K Hiroki, R Namatame
1Department of Anesthesiology, Kanagawa Children's Medical Center, Yokohama.
Insights
Pediatric anesthesia induction methods significantly impact serum myoglobin levels in children. Pretreatment with d-tubocurarine effectively mitigates succinylcholine-induced myoglobin increases during anesthesia induction.
Area of Science:
- Anesthesiology
- Biochemistry
Context:
- Pediatric general anesthesia involves specific induction methods.
- Serum myoglobin is a biomarker for muscle injury.
Purpose:
- To investigate the influence of different pediatric general anesthesia induction methods on serum myoglobin levels.
- To assess the efficacy of d-tubocurarine and thiopental pretreatment in modulating these changes.
Summary:
- Slow induction with nitrous oxide-oxygen-halothane followed by succinylcholine caused a significant increase in serum myoglobin.
- Pretreatment with d-tubocurarine reduced this increase, while thiopental did not.
- Rapid induction with thiopental and succinylcholine led to a slight increase, which was prevented by d-tubocurarine pretreatment.
- Serum myoglobin levels were not affected by age or fasciculations, but were significantly influenced by anesthesia induction methods.
Impact:
- Findings suggest that anesthetic induction protocols can be optimized to minimize muscle-related biomarker release in pediatric patients.
- This research provides insights into managing potential myoglobin release during pediatric anesthesia.
- Understanding these effects is crucial for patient safety and monitoring during pediatric surgical procedures.
Abstract:
Two hundred and twenty nine children from infancy to middle teens divided into six groups were studied to determine the effect of induction methods of pediatric general anesthesia on serum myoglobin. After the slow induction with nitrous oxide-oxygen-halothane (GOF), the serum myoglobin increased significantly to 1774.7 +/- 4285.8 ng.ml-1 (mean +/- SD) by iv administration of succinylcholine 1 mg.kg-1. This significant increase of serum myoglobin was reduced by pretreatment with d-tubocurarine (dTc) 0.05 mg.kg-1 before administration of succinylcholine. However, it was not reduced by pretreatment with thiopental 3 mg.kg-1. After the rapid induction with thiopental 5 mg.kg-1 and succinylcholine 1 mg.kg-1, the serum myoglobin increased slightly to 387.6 +/- 596.5 ng.ml-1. But this increase in serum myoglobin was stopped by pretreatment with dTc 0.05 mg.kg-1 before the rapid induction. Serum myoglobin was not changed without succinylcholine after the slow induction with GOF. In each group, there was no relation with serum myoglobin and ages or fasciculation. Serum myoglobin was more influenced by the induction methods of pediatric general anesthesia than by ages.