Meretoja O A
Department of Anaesthesia, Children's Hospital, University of Helsinki, Finland.
Anaesth Intensive Care. 1990 Nov;18(4):440-8. doi: 10.1177/0310057X9001800403.
This paper reviews the studies in which neuromuscular blocking drugs were compared in at least two different age groups of patients. Most recent studies have lead to a uniform concept of the variation of the effect of these drugs in different age groups. In general, the dose of a nondepolarizing agent required to produce a particular degree of relaxation is similar in neonates (less than one month), infants (one to twelve months) and adolescents (more than thirteen years). However, in children from three to ten years the dose is significantly greater. The maximal effect is reached more quickly in neonates and infants than in the older children and adolescents. These results can be explained by changes in sensitivity, distribution volume and muscle mass. The duration of effect of a nondepolarizing agent is significantly altered by age only in the case of vecuronium, which has a prolonged action in neonates and infants. Suxamethonium remains as the agent with the most rapid onset.
本文回顾了在至少两个不同年龄组患者中比较神经肌肉阻滞剂的研究。最近的研究得出了关于这些药物在不同年龄组中效果差异的统一概念。一般来说，产生特定程度松弛所需的非去极化剂剂量在新生儿（小于1个月）、婴儿（1至12个月）和青少年（超过13岁）中相似。然而，3至10岁儿童的剂量明显更大。新生儿和婴儿比大龄儿童和青少年更快达到最大效果。这些结果可以通过敏感性、分布容积和肌肉质量的变化来解释。仅维库溴铵的情况下，非去极化剂的作用持续时间会因年龄而显著改变，其在新生儿和婴儿中的作用时间延长。琥珀胆碱仍然是起效最快的药物。
