{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T19:11:31Z","timestamp":1772478691054,"version":"3.50.1"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Infants with hypertrophic pyloric stenosis have gastric outlet obstruction, indicating a pyloromyotomy. To prevent aspiration, a rapid sequence induction (RSI) of anesthesia used to be preferred. However, due to concerns about the side-effects of this technique in infants, a modified RSI with gentle mask ventilation is nowadays mostly used. This research investigates if induction with succinylcholine (classic RSI), cisatracurium (modified RSI), or no neuromuscular blocking agent (NMBA) influences time until extubation and incidence of complications in infants undergoing laparoscopic pyloromyotomy.<\/jats:p><jats:p>\n          Materials and Methods\u2003A retrospective chart review was performed, observing infants undergoing laparoscopic pyloromyotomy in Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, from January 2007 until July 2015. Baseline preoperative data, anesthesia and operation details, time to extubation, and reported complications were gathered. Inclusion criteria were maintenance of anesthesia with sevoflurane and a registered extubation time. Exclusion criteria were the use of combinations of NMBAs, repyloromyotomy, and conversion to laparotomy.<\/jats:p><jats:p>\n          Results\u2003A total of 168 patients were included, of which 21 received succinylcholine, 107 cisatracurium, and 40 no NMBA. Mean duration of surgery was 29\u2009minutes in all three groups; mean duration of anesthesia was 89, 82, and 77\u2009minutes; mean time to extubation was 26, 25, and 23\u2009minutes, respectively, without statistically significant difference. Complications were evenly distributed, no aspiration occurred.<\/jats:p><jats:p>\n          Conclusion\u2003The use of succinylcholine, cisatracurium, or no NMBA at induction of anesthesia in infants undergoing laparoscopic pyloromyotomy had no statistically significant effect on time until extubation and complication rates. A modified RSI seems to be safe and effective in these cases.<\/jats:p>","DOI":"10.1055\/s-0039-1692656","type":"journal-article","created":{"date-parts":[[2019,6,26]],"date-time":"2019-06-26T22:38:45Z","timestamp":1561588725000},"page":"440-446","source":"Crossref","is-referenced-by-count":4,"title":["Neuromuscular Blocking Agents and Rapid Sequence Induction for Laparoscopic Pyloromyotomy: Impact on Time to Extubation and Perioperative Complications"],"prefix":"10.1055","volume":"30","author":[{"given":"Dominique","family":"Swenker","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Erasmus Medical Centre-Sophia Children\u2019s Hospital, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"van der Knijff-van Dortmont","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Erasmus Medical Centre-Sophia Children\u2019s Hospital, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia","family":"Gonzalez Candel","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Erasmus Medical Centre-Sophia Children\u2019s Hospital, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Keyzer-Dekker","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lonneke","family":"Staals","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Erasmus Medical Centre-Sophia Children\u2019s Hospital, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,6,26]]},"reference":[{"key":"ref1","first-page":"207","volume-title":"Illustrated Textbook of Paediatrics. 3rd ed","author":"T Lissauer","year":"2007"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1111\/j.1460-9592.2012.03912.x","article-title":"Impact of rocuronium vs. succinylcholine neuromuscular blocking drug choice for laparoscopic pyloromyotomy: is there a difference in time to transport to recovery?","volume":"23","author":"E Ghazal","year":"2013","journal-title":"Paediatr Anaesth"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/01.ede.0000192032.83843.c9","article-title":"The continuing enigma of pyloric stenosis of infancy: a review","volume":"17","author":"B MacMahon","year":"2006","journal-title":"Epidemiology"},{"issue":"07","key":"ref4","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1111\/pan.12633","article-title":"Gas induction for pyloromyotomy","volume":"25","author":"G E Scrimgeour","year":"2015","journal-title":"Paediatr Anaesth"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.suc.2012.03.006","article-title":"Pyloric stenosis in pediatric surgery: an evidence-based review","volume":"92","author":"S Pandya","year":"2012","journal-title":"Surg Clin North Am"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1007\/s00383-009-2484-x","article-title":"New insights into the pathogenesis of infantile pyloric stenosis","volume":"25","author":"C Panteli","year":"2009","journal-title":"Pediatr Surg Int"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1111\/j.1651-2227.2001.tb00790.x","article-title":"Fluid resuscitation in infantile hypertrophic pyloric stenosis","volume":"90","author":"H H Miozzari","year":"2001","journal-title":"Acta Paediatr"},{"issue":"309","key":"ref8","doi-asserted-by":"publisher","DOI":"10.4172\/2155-6148.1000309","article-title":"Induction and airway management for pyloromyotomy","volume":"04","author":"A A Considine","year":"2013","journal-title":"J Anesth Clin Res"},{"issue":"01","key":"ref9","first-page":"207","article-title":"Recent changes in the package insert for succinylcholine chloride: should this drug be contraindicated for routine use in children and adolescents? 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