title: Clinical pharmacology of doxacurium chloride (BW A938U) in children.
abstract: The neuromuscular effects of doxacurium were studied in 26 children during halothane-nitrous oxide-oxygen anesthesia. Neuromuscular blockade was measured using electromyographic activity of the adductor pollicis muscle after supramaximal stimulation of the ulnar nerve at 2 Hz for 2 seconds at 10-second intervals. To estimate the cumulative dose-response relation, nine patients received incremental doses of doxacurium (2.5-10 micrograms/kg); nine patients received 27.5 micrograms/kg (the estimated ED95); eight patients received 50 micrograms/kg (1.8 X ED95). The ED25, ED50, ED75, and ED95 (estimated from linear regression plots of log dose vs probit of effect) were 11.5, 14.8, 19.0, and 27.3 micrograms/kg, respectively. Clinical duration (T25) was 27.8 +/- 10.3 (mean +/- SD) minutes at 1 X ED95 and 50.6 +/- 15.6 minutes at 1.8 X ED95. Time to recovery of the train-of-four ratio to 0.75 was 63.1 +/- 32.9 minutes at 1 X ED95 and 108.5 +/- 25.7 minutes at 1.8 X ED95. There were no significant changes in heart rate or mean arterial pressure after bolus administration of any dose of doxacurium.
authors.affiliation: Department of Anesthesiology, Children's Hospital of Pittsburgh, PA 15213.
authors.forename: J B
authors.initials: JB
authors.lastname: Sarner
authors.forename: B W
authors.initials: BW
authors.lastname: Brandom
authors.forename: D R
authors.initials: DR
authors.lastname: Cook
authors.forename: M L
authors.initials: ML
authors.lastname: Dong
authors.forename: M C
authors.initials: MC
authors.lastname: Horn
authors.forename: S K
authors.initials: SK
authors.lastname: Woelfel
authors.forename: P J
authors.initials: PJ
authors.lastname: Davis
authors.forename: G D
authors.initials: GD
authors.lastname: Rudd
authors.forename: V J
authors.initials: VJ
authors.lastname: Foster
authors.forename: B F
authors.initials: BF
authors.lastname: McNulty
mesh_terms: D000367:Age Factors; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007546:Isoquinolines / Q000494:pharmacology*; D009469:Neuromuscular Junction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*
chemical_list: D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; C049429:doxacurium