Infusion of atracurium in neonates, infants and children. A study of dose requirements.
نویسندگان
چکیده
The doses of atracurium (by infusion) required to maintain steady-state (90-95%) neuromuscular block were assessed in 75 children aged 9 days to 17 yr during balanced anaesthesia. Following the intubating dose of atracurium 0.4 mg kg-1 and after the recovery of single twitch to 5-10% of control (monitored by evoked EMG of hypothenar muscle), an infusion of atracurium 0.5 mg kg-1 h-1 was started. In 22 of the patients this initial rate resulted in the desired steady state; 32 patients required one, and 21 required two or more adjustments in rate. The mean single twitch value at steady-state was 6.6 +/- 0.3% (SEM), which is equal to 93% neuromuscular block. The infusion requirement to maintain the steady state neuromuscular block in all paediatric patients more than 1 month old was constant (0.53 +/- 0.01 mg kg-1 h-1). The infusion requirement of neonates up to 1 month old was 25% less (0.40 +/- 0.02 mg kg-1 h-1; P = 0.003). A significant correlation (n = 75, r = 0.76, P less than 0.001) was found between the infusion rate (mg m-2 h-1) and the logarithm of the body surface area.
منابع مشابه
Comparison of atracurium-induced neuromuscular blockade in neonates, infants and children.
The potency of atracurium was determined in neonates, infants and children during thiopentone-fentanyl-nitrous oxide in oxygen anaesthesia using single dose-response curves. The effective doses producing 50% depression of the first twitch of the train-of-four were significantly lower in neonates and infants than in children (82 and 112 v. 135 micrograms kg-1). Following a standard dose of atrac...
متن کاملEffects of Vitamin D in Neonates and Young Infants
Vitamin D is important for the development, growth, and mineralization of the skeletal in neonates and children. Vitamin D is essential for intestinal absorption of calcium. Vitamin D is metabolized to 25-hydroxyvitamin D and then to 1,25-dihydroxyvitamin D. Pregnant women in developed countries often have insufficient serum concentrations of 25-hydroxyvitamin D and a supplementation of vitamin...
متن کاملSynergism between atracurium and vecuronium in infants and children during nitrous oxide-oxygen-alfentanil anaesthesia.
This study was undertaken to see if infants are more sensitive than children to a combination of atracurium and vecuronium in an equipotent dose ratio: (microgram: microgram) 5:1 in infants and 4:1 in children. We studied 15 infants (1-11 months old) and 15 children (3-10 yr old) during nitrous oxide-oxygen-alfentanil anaesthesia. Neuromuscular function was recorded by adductor pollicis EMG. An...
متن کاملThe Investigation of Absorbed Dose in Gastroesophageal Reflax Imaging Procedure in Children and Neonates
Introduction: Nuclear medicine techniques have been widely employed in the assessment of gastroesophageal dysfunction. Gastroesophageal reflux (GER) is a common, self-limited process in infants and children that usually resolves at 12 to 18 months of age. Clinical management of GER includes conservative treatment, thickened feedings, positional therapy and parental reassurance. On the other han...
متن کاملUse of atracurium in neonatal anaesthesia.
Atracurium was administered to neonatal patients on 270 occasions without any difficulties being encountered. More detailed observations in 60 patients showed that, in 16 neonates 3 days of age and older, with a core temperature greater than 36 degrees C, the standard dose of atracurium 500 micrograms kg-1 had a mean duration of clinical effect of 23.1 +/- 3.4 min--the shortest in any group of ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- British journal of anaesthesia
دوره 60 6 شماره
صفحات -
تاریخ انتشار 1988