DIFFERENTIAL EFFECTS OF MYONEURAL BLOCKING DRUGS ON NEUROMUSCULAR TRANSMISSION IN INFANTS

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Abstract
Equipotent, paralyzing doses of pancuronium and tubocurarine were administered to 40 patients, aged from 1 day-12 mo., during N2O, O2 and fentanyl anesthesia. Neuromuscular activity was measured during onset and recovery from paralysis using train-of-4 stimulation. At the same depression of the 1st stimulus of the train, the train-of-4 ratio was decreased more during recovery than during onset each drug and more with tubocurarine than with pancuronium. These results are qualitatively similar to those found in adults, but the decrease in train-of-4 ratio was less in infants. Prejunctional neuromuscular activity, recognized as fade in response to train-of-4 stimulation, can be detected after administration of pancuronium or tubocurarine to infants, but that it is less marked than in adults.