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Pharmacokinetic properties of benzylisoquinolinium nondepolarizing neuromuscular blocking agents in infants, children, and adults*

Pharmacokinetic properties of benzylisoquinolinium nondepolarizing neuromuscular blocking agents in infants, children, and adults*
  Atracurium Cisatracurium
Infant Child Adult Elderly Infant Child Adult Elderly
ED95 (mg/kg) 0.16 to 0.20 0.25 0.25 0.25 0.04 0.05 0.05 0.05
VD (L/kg) 0.21 0.13 0.14 0.18 NA 0.21 to 0.35 0.12 to 0.26 0.14 to 0.26
t½-Beta (minutes) 14 to 20 14 to 20 21 22 NA 21 to 23 23 to 30 21 to 29
Onset time (minutes) 2 to 3 2 to 3 3 to 5 3 to 5 2.5 2.5 4 to 7 5 to 7
Dosing interval (minutes) 22 to 29 28 30 to 45 30 to 45 42 36 35 to 50 35 to 50
Onset times and dosing intervals are averages for a 2 × ED95 dose. Infant: 0 to 1 year; Child: 1 to 18 years; Adult: 18 to 65 years; Elderly: >65 years.
ED95: effective dose required to achieve 95% depression in evoked twitch response; VD: volume of distribution; t½-Beta: elimination half-life; NA: data not available.
* The data are averages obtained from published literature and do not account for other influences such as volatile anesthetics, organ dysfunction, etc.
Adapted from: Brull SJ. Neuromuscular blocking agents. In: Clinical Anesthesia, 8th ed, Barash PG, Cullen BF, Stoelting RK, et al (Eds), Wolters Kluwer 2017. p.527.
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