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Anesth Analg 2006;102:738-743
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000195342.29133.ce

PEDIATRIC ANESTHESIA

Pharmacokinetics and Pharmacodynamics of a 0.1 mg/kg Dose of Cisatracurium Besylate in Children During N2O/O2/Propofol Anesthesia

Karynn Imbeault, B Pharm, Davina E. Withington, FRCA, MRCP(UK), and France Varin, B Pharm, PhD

Faculté de Pharmacie, Université de Montréal, Department of Anesthesia, Montreal Children’s Hospital/McGill University, Montreal, Quebec, Canada

Address correspondence and reprint requests to France Varin, Faculté de Pharmacie, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, Qc., Canada (H3C 3J7). Address e-mail to france.varin{at}umontreal.ca.

We studied the pharmacokinetics and pharmacodynamics of cisatracurium in 9 children (mean weight, 17.1 kg) aged 1–6 yr (mean, 3.75 yr) during propofol-nitrous oxide anesthesia. Neuromuscular monitoring was performed. Venous samples were taken before injection of a 0.1 mg/kg dose of cisatracurium and then at 2, 5, 10, 30, 60, 90, and 120 min. Cisatracurium plasma concentrations were determined by high performance liquid chromatography. Onset time was 2.5 ± 0.8 min, recovery to 25% of baseline twitch height was 37.6 ± 10.2 min, and the 25%–75% recovery index was 10.9 ± 3.7 min. Distribution and elimination half-lives were 3.5 ± 0.9 min and 22.9 ± 4.5 min, respectively. Steady-state volume of distribution (0.207 ± 0.031 L/kg) and total body clearance (6.8 ± 0.7 mL/min/kg) were significantly larger than those published for adults. Pharmacodynamic results were comparable to those obtained in pediatric studies during halothane or opioid anesthesia with the exception of a longer recovery to 25% baseline. Although the plasma-effect compartment equilibration rate constant was twofold faster (0.115 ± 0.025 min–1) than that published for cisatracurium in adults, the effect compartment concentration corresponding to 50% block was similar (129 ± 27 ng/mL).






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 © 2006 by the International Anesthesia Research Society.