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British Journal of Anaesthesia, 1988, Vol. 61, No. 5 551-556
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia


research-article

POST-TETANIC COUNT AND INTENSE NEUROMUSCULAR BLOCKADE WITH VECURONIUM IN CHILDREN

S. A. RIDLEY, M.B., B.S., F.F.A.R.C.S.* and N. BRAUDE, M.B., CH.B., M.R.C.P., F.F.A.R.C.S.

The Hospitals For Sick Children Great Ormond Street, London WCIN 3JH

Sixty children undergoing surgery were allocated, according to weight, to three equal groups. Each child received a loading dose of vecuronium 80 µg kg–1 followed immediately by an infusion set initially at 1.4 µg kg–1 min–1. The subsequent intense neuromuscular blockade was assessed using the post-tetanic count (PTC). Maintaining the PTC between 5 and 15 ensured adequate paralysis which was antagonized easily 6–18 min after stopping the infusion. However, the duration of the initial intense block was unpredictable and the use of a peripheral nerve stimulator is advisable, particularly in smaller infants (<5 kg). The results suggest that vecuronium accumulated after 3 h infusion and that has less presynaptic effect than atracurium.

*Present address for correspondence: Clinical Shock Study Team, Western Infirmary, Glasgow G11 6NT.


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