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Iowa Neonatology Handbook: Pharmacology
Neuromuscular Blockers in Neonates
Jeffrey L. Segar, MD
Peer Review Status: Internally Peer Reviewed
Used to facilitate ventilation when the infant's respiratory efforts are not
coordinated with the ventilator. With the use of sedatives and synchronized
ventilation, this can usually be avoided.
Table 4. Dosage Recommendations for Neuromuscular Blocking Agents in
the Neonate
| Agent |
Ed95
(mg/kg) |
"Intubating Dose"
(mg/kg) |
Onset of Paralysis After Intubating
(min.) |
Dosage Intervals
(min.) |
|
Pancuronium |
0.05 |
0.15 |
1.5 - 2.0 |
60 - 120 |
|
Atracurium |
0.15 - 0.3 |
0.6 - 0.8 |
1.5 - 2.0 |
20 - 30 |
|
Vecuronium |
0.03 |
0.15 |
1.5 -2.0 |
30 - 40 |
|
Succinylcholine |
2.2 |
2 mg IV
4 - 5 mg IM |
0.5 - 1.0 |
5 - 10* |
* Not Recommended for prolonged duration. (From: Costarino & Polin, 1987)
When administering neuromuscular blockers, it is also necessary to administer
sedatives (includes narcotics).
ED95 = dose for effective response 95% of the time.
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