Evaluation of atracurium neuromuscular blockade in paediatric patients with burn injury.

The neuromuscular effects of atracurium were studied in acutely burned children, and in children at least 3 years after burn injury (controls). Thirty-one children were studied a total of 48 times. During nitrous oxide-narcotic anaesthesia, a single dose of atracurium was administered in each study and the twitch suppression recorded. Dose-response curves were established using least-squares regression techniques. The ED95 of atracurium in children recovered from burn injury was 0.27 mg kg-1, which is similar to that of normal children reported previously. During the first week of burn injury, the ED95 was 0.3 mg kg-1 irrespective of burn size, and was not significantly different from controls. After the first week of injury, in children with 20-60% body surface burn, the ED95 was twice normal, while in those with greater than 60% body surface burn, it probably may be increased up to 3.0 mg kg-1.