[Pharmacodynamics of vecuronium in infants during intravenous induction of anesthesia with ketamine].
The pharmacodynamic effects of vecuronium in children aged 1 to 6 years were investigated after intravenous induction of anaesthesia with ketamine, using an initial dose of vecuronium of 0.08 mg/kg body wt. 0.1 mg/kg body wt. The degree of neuromuscular blockade was determined by measuring the contraction force of the m. adductor pollicis after supramaximal stimulation of the ulnar nerve using an electromechanical device. The results (median, chi min and chi max) were as follows. For the initial dose 0.08 mg/kg body wt., the onset time was 150 s (110-360 s); total blockade: 5 of 9 children, D25 (duration of 25% recovery) 13 min (10-31); RI (recovery index): 8.5 min (6.0-14.5); D90 (duration of 90% recovery): 27 min (20-44). For the initial dose of 0.1 mg/kg body wt., the onset time was 135 s (80-300); total blockade: all children, D25: 19.5 min (12-32.5); RI: 8.75 min (6.5-13.5); D90 35 min (22-45). Only the D25 was significantly shorter using an initial dose of 0.08 mg/kg body wt. For a total blockade, a higher dose of vecuronium is necessary using intravenous induction of anaesthesia compared with previously described inhalation techniques. Even with the high dosage, recovery from neuromuscular blockade is so rapid in this age group that it can be used even for short operations without reversal.