Clinical evaluation of a new muscle relaxant. Pancuronium bromide

Abstract

With an initial dose of 0.1 to 0.15 mg/kg, sufficient and excellent muscular relaxation for endotracheal intubation can be obtained within 2 to 5 min after intravenous administration of pancuronium bromide, in man. A large dose of 3 mg/kg in total was used to maintain controlled respiration under moderate hypothermia, to treat a 6 yr old boy who had general convulsions and muscular twitching, which accidentally occurred postoperatively after open heart surgery for atrial septal defect. With reference to this case, none of the untoward reactions like tachyphylaxis or cumulative action and none of the untoward responses in the cardiovascular system were noted. Prolonged apnea lasting more than 2 hr was not observed, although a relatively large dose of pancuronium bromide had been used. Anti hypotensive action was noticed on the hypotension due to halothane anesthesia, possibly with reference to the steroid type of chemical structure as suggested by Bonta. The preoperative complications such as malnutrition, anemia and renal impairment in cancer patients deserve special attention, that is, a larger dose should be avoided.