Pharmacokinetics of Muscle Relaxants in Children

  • Dennis M. Fisher
Conference paper


Several studies in the early 1980’s improved our understanding of relationship of the physiologic changes with maturation to the pharmacokinetics of three nondepolarizing muscle relaxants, d-tubocurarine (dTc) (1), vecuronium (2), and atracurium (3). Because these muscle relaxants are polar, water-soluble molecules, their distribution should be limited to the extracellular fluid space (ECF). In fact, volume of distribution at steady state (Vss) of the three drugs correlates with ECF; its values are of the same order of magnitude as ECF (20–40% of body weight) and age-related changes parallel those of ECF. A second finding was that the neuromuscular junction of the neonate was sensitive (as defined by a lower steady state plasma concentration, Css, producing paralysis), consistent with the electromyographic findings of decreased prejunctional acetylcholine stores observed in neonates and infants (4,5).


Muscle Relaxant Interindividual Variability Plasma Cholinesterase Plasma Cholinesterase Activity Nondepolarizing Muscle Relaxant 
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Copyright information

© Springer Japan 1995

Authors and Affiliations

  • Dennis M. Fisher
    • 1
  1. 1.University of California, San FranciscoSan FranciscoUSA

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