Reversal of atracurium-induced neuromuscular block in paediatric patients.

Abstract:

:We studied the efficacy of neostigmine and edrophonium to reverse an atracurium-induced 90% neuromuscular block in 80 paediatric patients anaesthetized with thiopentone, fentanyl and nitrous oxide. The patients were divided into five age groups: 0-2 months, 3-11 months, 2-5 years, 6-10 years, and 11-15 years. At the end of surgery, the neuromuscular block was randomly antagonized with either neostigmine 50 micrograms kg-1 with atropine 20 micrograms kg-1 or with edrophonium 1 mg kg-1 with atropine 10 micrograms kg-1. In general, the first EMG response and train-of-four (TOF) ratio recovered fastest in the youngest age groups following either reversal agent (P < 0.05). However, in each age group edrophonium had a faster onset of effect than neostigmine (P < 0.05) even though a greater TAO-ratio was finally reached with neostigmine. The effects of neostigmine were less variable and more predictable than those of edrophonium. Therefore, we recommend the use of neostigmine for routine paediatric practice.

authors

Kirkegaard-Nielsen H,Meretoja OA,Wirtavuori K

doi

10.1111/j.1399-6576.1995.tb04196.x

subject

Has Abstract

pub_date

1995-10-01 00:00:00

pages

906-11

issue

7

eissn

0001-5172

issn

1399-6576

journal_volume

39

pub_type

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