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Vecuronium Infusion Requirements in Pediatric Patients during Fentanyl-N₂O-O₂ Anesthesia

Received from the Department of Anesthesiology, Children's Hospital, University of Helsinki, Helsinki, Finland.

Abstract

Eighty-one pediatric patients, ranging from neonates to adolescents, were studied during fentanyl-N₂OO₂ anesthesia to determine for each of them the vecuronium infusion required to maintain 90–95% neuromuscular block (NMB). Electromyographic monitoring with train-of-four stimuli was used. The steady infusion rate was 62 ± 15 (SD) µg·kg^–1·hr^–1 in neonates and infants. This rate was 40% of that required by children 3 to 10 years old (154 ± 49 µg·kg^–1·hr^–1; P < 0.05). In adolescents the vecuronium requirement was less than in children and was comparable to that reported in adults in other studies (89 ± 13 µg·kg^–1·hr^–1). Despite considerable individual variation, the infusion rate could be reliably estimated on the basis of duration of > 90% NMB maintained by small doses of vecuronium given after intubation. Also, a close correlation existed between the duration of > 90% NMB maintained by 100 µg/kg of vecuronium and the individual infusion rate (r² = 0.76).

Key Words: ANESTHESIA—pediatric • NEUROMUSCULAR RELAXANTS—vecuronium