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Atracurium infusion during paediatric craniofacial surgery. Closed loop control of neuromuscular block

C M Wait1, V A Goat

  • 1Nuffield Department of Anaesthetics, Radcliffe Infirmary, Oxford.

Anaesthesia
|July 1, 1989
PubMed

Insights

A feedback control system effectively managed neuromuscular blockade with atracurium in infants undergoing craniofacial surgery. This system ensured consistent blockade levels, proving its efficacy in pediatric patients.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Neuromuscular blockade is crucial in pediatric surgery.
  • Atracurium is a commonly used neuromuscular blocking agent.
  • Feedback control systems have shown efficacy in adults for managing neuromuscular blockade.

Purpose of the Study:

  • To evaluate the effectiveness of a simple feedback control system for atracurium administration in infants.
  • To assess the system's performance in pediatric patients undergoing complex craniofacial reconstruction.
  • To determine if the system, previously validated in adults, is suitable for pediatric use.

Main Methods:

  • A simple feedback control system was employed to administer atracurium.
  • Ten infants (5-36 months) undergoing craniofacial reconstruction were studied.
  • Neuromuscular block levels were monitored throughout the procedures.

Main Results:

  • The system successfully maintained neuromuscular block between 88-100% in all patients.
  • Nine out of ten patients achieved blockade levels of 90-100%.
  • Mean duration of feedback control was 179 minutes, with a mean atracurium dose of 0.40 mg/kg/hour and a mean recovery time of 24.8 minutes.

Conclusions:

  • A simple feedback control system is effective for administering atracurium in infants during craniofacial surgery.
  • The system provides reliable control of neuromuscular blockade in the pediatric population.
  • This technology offers a viable option for managing neuromuscular blockade in complex pediatric surgical procedures.

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