Potency of doxacurium in infants, children, and adolescents during N2O-O2-alfentanil anesthesia.
OBJECTIVE
To evaluate neuromuscular potency of doxacurium during balanced anesthesia in pediatric patients.


METHODS
Prospective, consecutive sample trial.


METHODS
Operating room at a university hospital.


METHODS
15 infants (1 to 11 months), 20 children (3 to 10 years), and 20 adolescents (13 to 19 years).


METHODS
Anesthesia was induced and maintained with thiopental, alfentanil, and nitrous oxide in oxygen. No volatile drugs were used at any time during the study. The neuromuscular function was recorded as adductor pollicis electromyography evoked by a train-of-four stimulation at 20-second intervals. A cumulative log-dose probit-response curve of doxacurium was established for every patient.


RESULTS
ED50 and ED95 doses of doxacurium (14 micrograms/kg and 25 micrograms/kg in infants, 26 micrograms/kg and 53 micrograms/kg in children, and 20 micrograms/kg and 41 micrograms/kg in adolescents, respectively) were smallest in infants and greatest in children (p < 0.05 between each pair of groups by analysis of variance and Scheffe's F-test).


CONCLUSIONS
Potency of doxacurium was greatest in infants and least in children. We suggest that doxacurium can be administered safely in infants, and with dosages close to those reported in adults. Children's dose requirement was almost 50% greater than that of infants.
Taivainen
T R
TR
Department of Anesthesiology, Children's Hospital University of Helsinki, Finland.
Meretoja
O A
OA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015760:Alfentanil; D000704:Analysis of Variance; D018686:Anesthetics, Intravenous; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007546:Isoquinolines / Q000627:therapeutic use*; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use*; D011446:Prospective Studies
D018686:Anesthetics, Intravenous; D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D015760:Alfentanil; C049429:doxacurium