Document Detail


Synergism between atracurium and vecuronium in infants and children during nitrous oxide-oxygen-alfentanil anaesthesia.
MedLine Citation:
PMID:  7826787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 individual dose-response curve of the atracurium-vecuronium combination was determined for every patient and its potency compared with that of the parent agents alone. The combination was significantly more potent than one parent agent, both in infants (P < 0.01) and in children (P < 0.0001). However, infants were less sensitive than children to synergism produced by the atracurium-vecuronium combination: if the ED50 dose of the parent agent is defined as one dose equivalent, then the mean ED50 doses of the combination were 0.81 (SEM 0.05) and 0.64 (0.03) dose equivalents in infants and children, respectively (P < 0.01). We suggest that an interaction between two binding sites of competitive neuromuscular blocking agents in postsynaptic acetylcholine receptors may explain both the synergism and sensitivity of infants to non-depolarizing neuromuscular blocking agents.
Authors:
O A Meretoja; T Taivainen; L Jalkanen; K Wirtavuori
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  73     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1995-02-21     Completed Date:  1995-02-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  605-7     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, Children's Hospital, University of Helsinki, Finland.
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MeSH Terms
Descriptor/Qualifier:
Alfentanil
Anesthesia, General*
Atracurium / administration & dosage*
Child
Child, Preschool
Dose-Response Relationship, Drug
Drug Synergism
Electromyography
Humans
Infant
Nitrous Oxide
Oxygen
Vecuronium Bromide / administration & dosage*
Chemical
Reg. No./Substance:
10024-97-2/Nitrous Oxide; 50700-72-6/Vecuronium Bromide; 64228-79-1/Atracurium; 71195-58-9/Alfentanil; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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