Since the introduction of muscle relaxants in clinical paediatric anaesthesia (Chapter I) controversies concerning their potency and pharmacodynamic behaviour have remained. Over the years it has been demonstrated that various factors influence the neuromuscular transmission. During growth from newborn to adulthood many of these factors change due to the process of maturation. Apart from changes in organ functions such as liver and kidneys, body composition is also undergoing constant change. All these changes will influence on pharmacoki netic parameters and thus the pharmacodynamic behaviour of the neuromuscular blocking agents. Until recently information about the potency and pharmacodynamics of muscle relaxants in neonates and infants has been scarce due to the problems in quatitation of neuromuscular blockade in these age groups (Chapter II). With the development of electromyographic quantitation of neuromuscular blockade more information has become available but, due to remaining inconsistency in anaesthetic technique and many other factors, comparison between the various studies is almost impossible. This has led to different recommendations concerning the use of muscle relaxants in paediatric anaesthesia. For example, some authors consider neonates resistent to nondepolarizing muscle relaxants, others more sensitive and yet others consider them to be equa 11 y senti ti ve to these drugs as adults. In our study we determined and compared the potency and pharmacodynamic behaviour of vecuronium bromide, an intermediately long-acting nondepolarizing muscle relaxant, in the various paediatric age groups under similar anaesthetic conditions and using the same el ectromyographi c method (EMG) for quantitation of neuromuscular blockade. From the various currently used nondepolarizing muscle relaxants we decided to study vecuronium bromide because of its minimal adverse effects compared to other relaxants (Chapter III).

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Erasmus University Rotterdam
W. Erdmann (Wilhelm) , L.H.D.J. Booij (Leo)
hdl.handle.net/1765/51140
Erasmus MC: University Medical Center Rotterdam

Schippers, H. (1988, February 24). Pharmacodynamics of vecuronium bromide in anaesthetized neonates, infants and children. Retrieved from http://hdl.handle.net/1765/51140