{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:09:35Z","timestamp":1790892575313,"version":"4.1.0"},"reference-count":72,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["U54 GM104941"],"award-info":[{"award-number":["U54 GM104941"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012465","name":"Nemours Foundation","doi-asserted-by":"publisher","award":["Un-numbered Award"],"award-info":[{"award-number":["Un-numbered Award"]}],"id":[{"id":"10.13039\/100012465","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011017","name":"American Academy for Cerebral Palsy and Developmental Medicine","doi-asserted-by":"publisher","award":["Pedal with Pete Foundation Award"],"award-info":[{"award-number":["Pedal with Pete Foundation Award"]}],"id":[{"id":"10.13039\/100011017","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swank Family Foundation","award":["Un-numbered Award"],"award-info":[{"award-number":["Un-numbered Award"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Individuals with spastic cerebral palsy (CP) often exhibit altered sensitivities to neuromuscular blocking agents (NMBAs) used for surgical intubation. We assessed usage of the NMBA rocuronium in patients with spastic CP and evaluated potential modifiers of dosing including gross motor function classification system (GMFCS) level, birthweight, gestational age, and the use of anticonvulsant therapy. In a case-control study, surgical patients with spastic CP (n = 64) or with idiopathic or non-neuromuscular conditions (n = 73) were enrolled after informed consent\/assent. Patient data, GMFCS level, anticonvulsant use, and rocuronium dosing for intubation and post-intubation neuromuscular blockade were obtained from medical records. Findings reveal participants with CP required more rocuronium per body weight for intubation than controls (1.00 \u00b1 0.08 versus 0.64 \u00b1 0.03 mg\/kg; p &lt; 0.0001). Dosing increased with GMFCS level (Spearman\u2019s rho = 0.323; p = 0.005), and participants with moderate to severe disability (GMFCS III-V) had elevated rocuronium with (1.21 \u00b1 0.13 mg\/kg) or without (0.86 \u00b1 0.09 mg\/kg) concurrent anticonvulsant therapy. Children born full-term or with birthweight &gt;2.5 kg in the CP cohort required more rocuronium than preterm and low birthweight counterparts. Individuals with CP exhibited highly varied and significant resistance to neuromuscular blockade with rocuronium that was related to GMFCS and gestational age and weight at birth.<\/jats:p>","DOI":"10.3390\/jpm11080765","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T08:16:39Z","timestamp":1627978599000},"page":"765","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Resistance to Neuromuscular Blockade by Rocuronium in Surgical Patients with Spastic Cerebral Palsy"],"prefix":"10.3390","volume":"11","author":[{"given":"Stephanie","family":"Lee","sequence":"first","affiliation":[{"name":"Nemours Biomedical Research, Nemours-Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karyn","family":"Robinson","sequence":"additional","affiliation":[{"name":"Nemours Biomedical Research, Nemours-Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Lodge","sequence":"additional","affiliation":[{"name":"Nemours Biomedical Research, Nemours-Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Theroux","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Nemours-Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freeman","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Nemours-Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Robert","family":"Akins","sequence":"additional","affiliation":[{"name":"Nemours Biomedical Research, Nemours-Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,3]]},"reference":[{"key":"ref_1","unstructured":"(2021, May 31). 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