Abstract
Objective To evaluate the effects of promethazine or dexamethasone pretreatment on histamine release induced by mivacurium in pediatric patients.Methods Eighty pediatric patients,of ASA physical status Ⅰ or Ⅱ,aged 4-10 yr,weighing 14-30 kg,scheduled for elective tonsillectomy and adenoidectomy,were randomized into 4 groups (n =20 each) using a random number table:rocuronium group (group R),mivacurium group (group M),dexamethasone + mivacurium group (group DM) and promethazine + mivacurium group (group PM).Dexamethasone 0.2 mg/kg and promethazine 0.5 mg/kg were injected intramuscularly at 60 min before anesthesia in DM and PM groups,respectively.Anesthesia was induced with midazolam,propofol,fentanyl and rocuronium 600 μg/kg (in group R) or mivacurium 200 μg/kg (in M,MD and MP groups).At 1 min before administration of muscle relaxants and 1,3 and 5 min after administration of muscle relaxants,MAP and HR were recorded,blood samples were taken from the radial artery for determination of plasma histamine concentrations,and the cutaneous adverse reactions were observed.Results Compared with group R,MAP was significantly decreased at T1-3,HR and plasma histamine concentrations were increased at Ti,2,and the grade of cutaneous adverse reactions was increased in group M,MAP was decreased at T1,2,HR was increased at T1-3,plasma histamine concentrations were increased at T1 in group DM,and plasma histamine concentrations were increased at T1 in group PM.Compared with group M,MAP was significantly increased at T2 in group DM,MAP was increased and HR was decreased at T1-3,plasma histamine concentrations were decreased at T1,2 in group PM,and the grade of cutaneous adverse reactions was decreased in DM and PM groups.Conclusion Promethazine pretreatment can decrease the mivacurium-caused release of histamine in pediatric patients,while dexamethasone pretreatment has no such effects. Key words: Dexamethasone ; Promethazine ; Ischemic preconditioning; Androstanols ; Histamine ; Child
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