Premium
Influence of age on the dose‐response relationship of atracurium in paediatric patients
Author(s) -
Meretoja O. A.,
Wirtavuori K.
Publication year - 1988
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1988.tb02797.x
Subject(s) - medicine , anesthesia , fentanyl , atracurium besilate , neuromuscular monitoring , neuromuscular transmission , neuromuscular blockade , pediatrics
To assess the influence of age on the dose‐response relationship of atracurium in paediatric patients during thiopental‐fentanyl‐N 2 O‐O 2 ‐anaesthesia, we studied 85 patients from neonates to adolescents. Each patient was given two doses of atracurium: following the maximum EMG response to the first dose of 150 μg/kg, an individual second dose was given, to produce exactly 95% neuromuscular block. The onset time of atracurium (time from administration to maximum effect) was shortest in neonates (2.6 min) and infants (3.3 min) and longest in adolescents (5.5 min) ( P <0.01). The dose‐response curves were parallel in all patients aged 3 months or older. The ED 95 of atracurium was comparable for neonates and infants (226 μg/kg). This was 28% less than the ED 95 for patients aged 1 year or older (316 μg/kg) ( P <0.01). The results explain the slightly longer‐lasting neuromuscular block in infants as compared to children following a constant atracurium dose in μg/kg. The great individual variability of the neuromuscular response, however, indicates that neuromuscular monitoring is essential in paediatric patients.