IS VECURONIUM A LONG-ACTING NEUROMUSCULAR BLOCKING AGENT IN NEONATES AND INFANTS?

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Abstract
Vecuronium was used as the only neuromuscular blocking agent in 81 paediatric patients (neonates to adolescents) during fentanyl and nitrous oxide anaesthesia. The thenar electromyogram was used to monitor neuromuscular blockade. Neonates and infants had a mean requirement of vecuronium 105 μg kg−1 during the first 1 h of anaesthesia, to establish and maintain 90–98% neuromuscular blockade, compared with a mean requirement of 217 μg kg−1 for children aged 3–10 yr (P < 0.05). Vecuronium 100 and 150 μg kg−1 maintained neuromuscular blockade > 90% for 59 and 110 min, respectively, in neonates and infants, but only for 18 and 38 min in children and for 37 and 68 min in adolescents (P < 0.05). Vecuronium may be regarded as a long-acting neuromuscular blocking agent in patients aged less than 1 yr.