• Sheung-Nyoung Choi, Young-Eun Jang, Ji-Hyun Lee, Eun-Hee Kim, Jin-Tae Kim, and Hee-Soo Kim.
• From the Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital (S-N C, Y-E J, J-H L, E-H K, J-T K, H-S K), Department of Anaesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea (H-S K).
• Eur J Anaesthesiol. 2019 Mar 1; 36 (3): 194-199.

BackgroundMinimising rocuronium administration during paediatric surgery helps to reduce the incidence of residual muscular blockade.ObjectiveTo determine whether intermittent bolus injection (Bolus group) or continuous infusion (group) requires the lesser amount of rocuronium.DesignA randomised, single-blind controlled trial.SettingA single university hospital from March to June 2017.PatientsSixty-six children undergoing general anaesthesia.InterventionsDose of rocuronium for maintenance of muscle relaxation in either Bolus or continuous infusion group. Train-of-four (TOF) count of two was maintained during surgery. When TOF count reached three, 0.1 mg kg of rocuronium was administered in Bolus group or infused at an increased rate of 0.1 mg kg h in continuous infusion group.Main Outcome MeasuresPrimary outcome was the dose of rocuronium given (μg kg min). The recovery time from the TOF count four to TOF 0.7 (RT0.7), and 0.9 (RT0.9) were recorded. All adverse events were recorded up to 30 min after extubation.ResultsMean (SD) rocuronium dose in the Bolus group was 6.1 (0.9), [95% confidence interval (95% CI) 5.7 to 6.4] μg kg min and 4.9 (1.0), (95% CI 4.6 to 5.3) μg kg min in the continuous infusion group (P = 0.001). RT0.7 was 24.0 (13.7), 95% CI 19.3 to 28.7) min in the Bolus group, and 25.7 (16.0), (95% CI 20.2 to 31.2) min in the continuous infusion group (P = 0.73). RT0.9 was 30.7 (17.1), (95% CI 24.9 to 36.5) min in the Bolus group, and 30.0 (17.6), (95% CI 24.0 to 36.0) min in the continuous infusion group (P = 0.91). The incidence of adverse events was not significantly different between two groups.ConclusionIn children undergoing general anaesthesia, the dose of rocuronium given by continuous administration was less than that with intermittent bolus.Trial RegistrationClinicalTrials.gov (identifier: NCT03060707).

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