Safety and efficacy of vecuronium in adolescents and children

The neuromuscular and cardiovascular effects of vecuronium (Norcuron, ORG NC45) were studied in 40 adolescents (10-17 yr) and children (2-9 yr) anesthetized with 1.5% inspired halothane. Ten adolescents and ten children were given 20 micrograms/kg incremental doses of vecuronium to establish a cumulative dose-response curve during train-of-four stimulation. The ED95 dose was 56 micrograms/kg in children and 40 micrograms/kg in adolescents, children being significantly (P less than 0.01) more resistant to the neuromuscular effects of vecuronium than adolescents. Another group of 10 children and 10 adolescents received a bolus dose of 80 micrograms/kg. This dose provided satisfactory conditions for endotracheal intubation with complete suppression of train-of-four response in all adolescents and children within 2 min. Thereafter, the twitch tension recovered to 5% of control twitch height in 18.5 +/- 1.5 min, to 25% in 24.4 +/- 1.6 min, and to 95% in 43.3 +/- 2.1 min. Vecuronium (20-80 micrograms/kg) did not significantly alter the heart rate or blood pressure nor did it affect kidney or liver function as assessed by routine clinical laboratory tests. Vecuronium is a useful nondepolarizing neuromuscular blocking agent with a short to intermediate duration of action, which can be used safely in children and adolescents.