29 September 2025 : Review article
Age-Specific Pharmacology of Neuromuscular Blocking Agents: A Comprehensive Review
Paweł Radkowski
ABCDEFG 1,2,3, Kacper Kowalczyk ABCDEF 4, Anna Łęczycka ABCDEF 4, Hubert Oniszczuk BDE 5*, Łukasz Grabarczyk DEFG 6
DOI: 10.12659/MSM.949656
Med Sci Monit 2025; 31:e949656
Table 3 NMBAs doses allowing endotracheal intubation according to age.
| Children | Adults | Elderly | |
|---|---|---|---|
| Succinylcholine | 2–3 mg/kg 0–12 months1–2 mg/kg 1–12 years | 1 mg/kg | 1 mg/kg |
| Non-depolarizing agents – benzylisoquinolones | |||
| Atracurium | 0.3–0.4 mg/kg 0–12 months0.5 mg/kg 1–12 years | 0.5 mg/kg | 0.5 mg/kg |
| Cisatracurium | 0.15 mg/kg | 0.15–0.2 mg/kg | 0.1–0.15 mg/kg |
| Mivacurium | 0.15–0.2 mg/kg | 0.15–0.25 mg/kg | 0.15–0.25 mg/kg |
| Pancuronium | 0.06–0.1 mg/kg with lower doses within the range for children 0–7 years old | 0.1 mg/kg initial dose or 0.7–2 μg/kg/min continuous infusion | 0.1 mg/kg initial dose or 0.7–2 μg/kg/min continuous infusion |
| Vecuronium | 0.1 mg/kg | 0.1 mg/kgin RSI 0.1–0.2 mg/kg | 0.1 mg/kg |
| Rocuronium | 0.3–0.6 mg/kg with lower doses within the range for children below 4 months old or in specific conditions | 0.6 mg/kgin RSI 1.0–1.2 mg/kg | 0.6–1.0 mg/kg |
| Neostigmine | 0.02–0.05 mg/kg (with atropine 0.02 mg/kg) | 0.02–0.05 mg/kg (with atropine 0.02 mg/kg) | 0.04–0.05 mg/kg (with atropine 0.02 mg/kg) |
| Sugammadex | 2 mg/kg above 2 years (same dose below 2 years, but it is off-label) | 2–16 mg/kg | 2.0–8.0 mg/kg |