The response to muscle relaxants and the dose required change during growth from birth to adolescence. Some physiological factors such as development of neuromuscular junction, the different distribution of the muscle fibres, and the extracellular fluid compartment affect the non depolarizing muscle relaxant (NDMR) ED 95, onset time and recovery time. Infants under 1 year of age are more sensitive to the NDMR and need less drug; children aging more than 1 year are more resistant and need a larger amount of drug; the reversal of the neuromuscular blockade before extubation, is extremely important especially in infants with long-acting agents.
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