{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T16:53:01Z","timestamp":1775580781888,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T00:00:00Z","timestamp":1611273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Infants undergoing pyloromyotomy are at a high risk of aspiration, making rapid sequence induction the preferred method of induction. Since succinylcholine use in infants can be associated with complications, rocuronium is frequently substituted despite its prolonged duration of action.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To examine the likelihood of non\u2010reversibility to neostigmine at the end of surgery in laparoscopic pyloromyotomies and its correlation to both rocuronium dose and out of operating room time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis, received rocuronium, and were reversed with neostigmine were included. Bayesian multivariable logistic regression was utilized to determine the probability of non\u2010reversibility, and Bayesian multivariable median regression was performed to ascertain the correlation between out of operating room time and non\u2010reversibility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>306 patients were analyzed with a median surgical duration of 19\u00a0min (interquartile range 16 to 23). 74% received succinylcholine for intubation followed by rocuronium, and the remaining received rocuronium alone. The median rocuronium dose was 0.41\u00a0mg\/kg (interquartile range 0.27 \u2013 0.56\u00a0mg\/kg). Prolonged block occurred in 68 (22.2%) patients. There was a non\u2010trivial probability of prolonged block with low rocuronium doses, and each 0.1\u00a0mg\/kg increase in total rocuronium dose was associated with an odds ratio of 1.36 (95% credible interval: 1.17\u20131.58) of neostigmine non\u2010reversibility at the end of surgery. Non\u2010reversibility was correlated with a substantial increase in median out of operating room time (13.4\u00a0min, 95% credible interval: 5.5\u201320.8\u00a0min), which was compounded by high rocuronium dosing (2.2\u00a0min increase per 0.1\u00a0mg\/kg for doses greater than 0.5\u00a0mg\/kg, 95% credible interval: 0.7\u20133.6\u00a0min).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prolonged blockade can occur from rocuronium administration in infants undergoing pyloromyotomy even at low doses. Therefore, consideration of appropriate rocuronium dosing or the use of sugammadex should be considered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14118","type":"journal-article","created":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T16:16:27Z","timestamp":1609431387000},"page":"290-297","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prolonged neuromuscular block after rocuronium administration in laparoscopic pyloromyotomy patients: A retrospective bayesian regression analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5501-8943","authenticated-orcid":false,"given":"Laura E.","family":"Gilbertson","sequence":"first","affiliation":[{"name":"Department of Pediatric Anesthesiology Children\u2019s Healthcare of Atlanta Emory University School of Medicine Atlanta GA USA"},{"name":"Department of Pediatrics Children\u2019s Healthcare of Atlanta Emory University School 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