TYK154

Which of the following explains the observation that 0.1 mg/kg of vecuronium produces the same clinical effect in neonates as in adults?

a) The sensitivity of the neuromuscular junction to vecuronium is the same across age groups

b) The decreased sensitivity of neonates to NMBAs is offset by the decreased volume of distribution (and higher plasma levels)

c) The increased sensitivity of neonates to NMBAs is offset by the increased volume of distribution (and lower plasma levels)

d) 0.1 mg/kg of vecuronium does NOT produce the same clinical effect in neonates as in adults

e) A and C are correct

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Answer

Answer c.

As described above, the combination of fewer presynaptic ACh vesicles (causing increased sensitivity to NMBAs) and large extracellular water compartment (leading to a large Vd and lower plasma levels) results in a balanced effect and no change in required dose of non-depolarizing agents in neonates.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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