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Anesth Analg 1988; 67:21-26
© 1988 International Anesthesia Research Society
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Age-Dependence of the Dose-Response Curve of Vecuronium in Pediatric Patients during Balanced Anesthesia

Olli A. Meretoja, MD, Kari Wirtavuori, MD, and Pertti J. Neuvonen, MD

Received from the Department of Anesthesiology, Children's Hospital, and the Departmentof Clinical Pharmacology, University of Helsinki, Finland.

Abstract

The effect of age on the log-based cumulative dose-response curve of vecuronium wasdetermined in ten age groups of 80 pediatric patients ranging from neonates to adolescents during thiopental-fentanyl-N2O/O2 anesthesia. Neuromuscular blockwas recorded as the evoked thenar electromyographic response to train-of-four stimulation of the ulnar nerve (2 Hz at 20-second intervals). The dose-response curves were parallel to each other in all ten age groups studied. In neonates and infants, the ED, of vecuronium was 47 ± 11 (so) pg/kg. This was significantly lower than the ED, of81 ± 12 pg/kg in children between 3 and 10 years of age (P > 0.01). In patients aged 13 years or older, the ED95, was 55 ± 12 pg/kg, which did not differ from the neonatal and infant values but was significantly lower than the ED95 of children between 3 and 10 years of age. The results indicate that the dose of vecuronium necessary for tracheal intubation is age-dependent. The individual ED95 values varied between 22 and 103 pg/kg. This suggests that an individually optimal dose of vecuronium can be administered to pediatric patients only if neuromuscular block is adequately monitored.

Key Words: NEUROMUSCULAR RELAXANTS—vecuronium • ANESTHESIA—pediatric




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1988 by the International Anesthesia Research Society.