• Zhou Xiang, Qu Yan-Liang, Song Xiao-Yang, Zhang Yan-Hui, Chen Min, Gan Guo-Shen, Wu Ming-Chun, Luo Zhong-Bing, Wang Qing-Li, Hu Guang-Jun, Qin Ming-Zhe, and Tao Jun.
• Department of Anesthesiology, Wuhan General Hospital of Guangzhou Command, Wuhan, Hubei, China.
• Paediatr Anaesth. 2014 Mar 1; 24 (3): 322-6.

ObjectiveTo determine the effects of pretreatment with either promethazine or dexamethasone on mivacurium-induced histamine release in children.MethodsEighty ASA I-II children (4-10 years of age) scheduled for tonsillectomy and/or adenoidectomy were randomly divided into 4 groups (n = 20 per group) designated as either the rocuronium, mivacurium, dexamethasone (DXM), or promethazine group. Children in the DXM and promethazine groups were treated separately with intramuscular DXM 0.2 mg·kg(-1) or promethazine 0.5 mg·kg(-1) injections 60 min before operation. Radial artery blood samples were collected to quantify plasma histamine concentrations 1 min before and 1, 3, and 5 min after administration of the relaxant. Mean arterial pressure (MAP), heart rate (HR), and skin flushing were recorded at the same time.ResultsNo significant decreases in plasma histamine concentrations were observed between groups; however, more stable MAP and HR and less skin flushing were observed in DXM group participants compared with individuals in the mivacurium group (P < 0.05). By contrast, children in the promethazine group had significantly decreased plasma histamine concentrations and stable MAP and HR (without a significant increase in HR) compared with patients in mivacurium group. In addition, skin flushing was significantly decreased compared with that observed in the rocuronium group (P < 0.05).ConclusionsPretreatment with promethazine significantly decreased mivacurium-induced histamine release in children and provided stable hemodynamics during administration of anesthesia.© 2013 John Wiley & Sons Ltd.

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