Response to nondepolarizing muscle relaxants in children with tumours.
The rate of onset of action of d-tubocurarine (64 patients) or alcuronium (36 patients) was studied electromyographically in 100 children who had abdominal, bone or cerebral tumours. It was found that there was a significantly delayed onset (over three times longer than controls) or additional doses were required in patients with malignant liver, renal and bone tumours who received d-tubocurarine. The onset of alcuronium blockade was also prolonged but to a lesser extent. When tumours with an abnormal prolongation of onset of relaxation were successfully treated by chemotherapy and/or surgery, the response reverted to normal. Children with benign tumours or masses had normal responses. In contrast, neuroblastomas were associated with little prolongation of onset. Cerebral tumours showed a variable response, with the observed changes being unreliable indicators of degree of malignancy.
Brown
T C
TC
Department of Anaesthesia, Royal Children's Hospital, Melbourne, Victoria, Australia.
Gregory
M
M
Bell
B
B
Clare
D
D
D000293:Adolescent; D000443:Alcuronium / Q000008:administration & dosage / Q000494:pharmacology*; D001859:Bone Neoplasms / Q000503:physiopathology; D001932:Brain Neoplasms / Q000503:physiopathology; D002648:Child; D004305:Dose-Response Relationship, Drug; D004576:Electromyography; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000503:physiopathology; D008113:Liver Neoplasms / Q000503:physiopathology; D009119:Muscle Contraction / Q000187:drug effects; D009369:Neoplasms / Q000473:pathology / Q000503:physiopathology*; D009447:Neuroblastoma / Q000503:physiopathology; D009469:Neuromuscular Junction / Q000187:drug effects; D013997:Time Factors; D014403:Tubocurarine / Q000008:administration & dosage / Q000494:pharmacology*; D009396:Wilms Tumor / Q000503:physiopathology
D000443:Alcuronium; D014403:Tubocurarine