Post-tetanic count and intense neuromuscular blockade with vecuronium in children.

Sixty children undergoing surgery were allocated, according to weight, to three equal groups. Each child received a loading dose of vecuronium 80 micrograms kg-1 followed immediately by an infusion set initially at 1.4 micrograms kg-1 min-1. The subsequent intense neuromuscular blockade was assessed using the post-tetanic count (PTC). Maintaining the PTC between 5 and 15 ensured adequate paralysis which was antagonized easily 6-18 min after stopping the infusion. However, the duration of the initial intense block was unpredictable and the use of a peripheral nerve stimulator is advisable, particularly in smaller infants (less than 5 kg). The results suggest that vecuronium accumulated after 3 h infusion and that has less presynaptic effect than atracurium.