Effect of mivacurium 200 and 250 μg/kg in infants during isoflurane anesthesia: a randomized controlled trial [ISRCTN07742712]

BACKGROUND: Infants usually respond differently to a neuromuscular relaxant compared to children or adults. Isoflurane is commonly used as an anesthetic gas in infants. In an RCT design, we investigated whether a dose of mivacurium 250 μg/kg results in faster onset of action than 200 μg/kg in infants under isoflurane anesthesia. Spontaneous recovery times and cardiovascular response were also evaluated. METHODS: Twenty-four low surgical risk children, aged 6–24 months, undergoing an elective surgery and requiring tracheal intubation were selected. After anesthetic induction, patients randomly received an iv bolus dose of mivacurium 200 or 250 μg/kg. After maximal relaxation, the patient was intubated. Isoflurane was administered to maintain anesthetic level during the surgical procedure. Neuromuscular function was monitored by accelerometry (TOF-Guard) at the adductor pollicies. The first twitch (T) of the TOF and the T4/T1 were measured. The time-course of heart rate and systolic and diastolic blood pressure were analysed by transforming them into their respective areas under the curve. RESULTS: Mivacurium 250 μg/kg produced a maximal T block faster than 200 μg/kg, i.e. 2.4 ± 1.1 vs. 3.5 ± 1.4 min (p < 0.05). Spontaneous recovery times were similar in both groups. Heart rate was similar between doses while systolic and diastolic blood pressures were lower with the higher dose (p < 0.05). Flushing was observed in two cases, one in each group. CONCLUSIONS: The maximal effect of mivacurium 250 μg/kg, in infants under isoflurane anesthesia, was present one minute faster than 200 μg/kg. However, it produced a significant cardiovascular response

Uso do Índice de Massa Corporal na avaliação do estado nutricional de adultos indígenas Xavánte, Terra Indígena Sangradouro-Volta Grande, Mato Grosso, Brasil Use of Body Mass Index to evaluate the nutritional status of Xavánte Indigenous adults, Sangradouro-Volta Grande, Mato Grosso State, Central Brazil

Este artigo examina as relações entre o Índice de Massa Corporal (IMC) e medidas antropométricas de composição corporal de adultos Xavánte, da aldeia São José, Terra Indígena Sangradouro-Volta Grande, Mato Grosso, Brasil, a fim de analisar a potencialidade do IMC como instrumento de avaliação do estado nutricional desse grupo indígena. O trabalho de campo foi realizado em janeiro e fevereiro de 1999, sendo aferidas medidas de massa corporal (MC); estatura (EST); perímetro braquial (PB), do quadril (PQUA) e do abdômen (PABD), e dobra cutânea tricipital (DCT) de 128 indivíduos. Os achados indicam, para ambos os sexos, uma alta correlação (r > 0,80) dos valores de IMC com a MC, PB e PABD. Houve, ainda, alta correlação do IMC com as áreas total e de gordura do braço, para as mulheres, e com o PQUA e a área total do braço, para os homens. Esses resultados sugerem que altos valores de IMC indicam excesso de tecido adiposo entre os Xavánte. Diante das evidências de um intenso processo de transição nutricional, resultando em aumento nas freqüências de sobrepeso e obesidade em adultos, é importante monitorar o perfil nutricional dos povos indígenas no Brasil.<br>This study evaluates the relationship between Body Mass Index (BMI) and anthropometric measurements in Xavánte adults on the Sangradouro-Volta Grande Indian Reservation, Mato Grosso State, Central Brazil. The objective was to analyze the use of BMI as an indicator of nutritional status in this specific population. Fieldwork was conducted in January-February 1999. Data include body mass, height, arm, hip, and waist circumference, and triceps skinfold of 128 adults over 20 years of age. The results indicate high correlations (r > 0.80) between BMI and body mass and waist and mid upper arm circumference for both sexes. For women, fat arm area and total arm area were also highly correlated with BMI, while for men hip circumference and total arm area showed a high correlation with BMI. The results suggest that high BMI values are related to excess fat among the Xavánte. It is important to monitor changes in the nutritional status of indigenous peoples in Brazil, since there is evidence that such populations are undergoing rapid processes of nutritional transition