Age-Dependence of the Dose-Response Curve of Vecuronium in Pediatric Patients during Balanced Anesthesia

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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.

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