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At least 253 records · Page 14Linked to original sources
PubMed1988

[Effect of pancuronium bromide on the adherence of polymorphonuclear neutrophilic granulocytes in vitro].

Infection is still an important problem following surgery. Polymorphonuclear neutrophil granulocytes (PMN) play a vital role in host defenses against invading bacteria; thus, adverse effects on PMN caused by anesthetic agents are of general interest. In this study, we examined the influence of pancuronium bromide on PMN adherence in vitro. Heparinized venous blood samples were obtained from 18 healthy male adult donors. Each specimen was divided. One part was used to determine the adherence of untreated PMN, while pancuronium bromide was added to the other. Two concentrations (1.3 or 0.5 micrograms relaxant/ml blood) were tested. PMN adherence was studied using nylon fiber columns as described by MacGregor et al. Both concentrations of pancuronium bromide caused an inhibition of adherence, which was significant in the case of the higher dosage (p less than 0.05). There is a direct correlation between the intensity of PMN adherence and the extent of granulocyte delivery to sites of inflammation. Therefore, it seems possible that clinical concentrations of pancuronium bromide may be able to increase the risk of developing bacterial infections. Further studies concerning this problem should be conducted.

Adult↗
PubMed1987

Effects of a low dose of pancuronium on oxygen consumption during sustained muscular exercise.

The effects of a low dose of pancuronium on muscular performance were studied in six healthy volunteers. Three dynamic exercise tests at increasing levels of power were performed by each subject on two consecutive days using an ergometric bicycle. To assess muscular function, oxygen consumption was measured in a steady state at each level of power output. Pancuronium 6-8 micrograms kg-1 or placebo was administered i.v. in a double-blind fashion before the second test each day. Plasma pancuronium levels were measured 8 min after administration but even with pancuronium clearly detectable in the plasma no significant differences were found either in oxygen consumption or in the haemodynamic measurements made. The authors conclude that such doses of non-depolarizing neuromuscular blocking agents do not disturb oxygen consumption during dynamic muscular exercise and are therefore unlikely to have a significant effect on muscular function.

Adult↗
PubMed1979

[Precurarization using pancuronium in male subjects. Evaluation of certain clinical effects].

The authors studied certain effects in the male subject of precurarisation using different doses of pancuronium. The results obtained show that the maximum doses used, corresponding to 0.01 Omg/kg of pancuronium, were associated with subjective symptoms which were well tolerated by the conscious patient, a decreases in the incidence of fasciculations, antagonistic effects against succinylcholine and a decreases in postoperative myalgia. In their conclusion, the authors confirm that the maximum doses of pancuronium used require an increase in doses of succinylcholine in order to avoid the antagonism phenomenon, and that doses ranging from 0.010 to 0.020 mg/kg of pancuronium could be used in order to completely eliminate postoperative myalgia related to succinylcholine.

Adult↗
PubMed1985

Cardiac electrophysiologic effects of pancuronium.

A microelectrode examination of guinea pig left ventricular papillary muscle was performed to determine whether there was a direct effect of pancuronium on cardiac cells and, if so, to attempt to ascertain the mechanism of this effect. Electrical events were measured before and during superfusion with pancuronium, epinephrine, propranolol, and verapamil; alone and in various combinations. Pancuronium prolonged the duration of the action potential (AP); increased resting potential (Em), AP magnitude, and rate of rise of the AP (dV/dt); and resulted in spontaneity in 12% of the muscles. Epinephrine and pancuronium combined caused spontaneity in 80% of the muscles and oscillatory behavior. Additionally, this combination decreased AP magnitude, Em, and dV/dt in several preparations--a pattern of response similar to that seen in ouabain-treated myocardial cells under the influence of catecholamines. These changes were always reversed by verapamil or by perfusion with a drug-free medium, and were usually reversed by propranolol. The data suggest a combined pancuronium/epinephrine induced increase in cardiac membrane permeability to Ca2+.

Action Potentials↗
PubMed1979

Gallamine and pancuronium inhibit pre- and postjunctional muscarine receptors in canine saphenous veins.

The influence of gallamine, pancuronium, suxamethonium and d-tubocurarine on adrenergic neurotransmission was studied in the isolated saphenous vein of the dog. Pancuronium but not the other muscle relaxants increased significantly the response to sympathetic stimulation and to exogenous norepipephrine; these increases were abolished after blockade of neuronal uptake by cocaine. Pancuronium and gallamine inhibited both the relaxation produced by lower doses of acetylcholine added during sympathetic stimulation (prejunctional effect) and the direct contractions evoked by high doses of the amine (postjunctional effect). In strips previously incubated with [3H]norepinephrine, gallamine had no effect on [3H]norepinephrine efflux in basal conditions and during sympathetic stimulation; it increased markedly the efflux evoked by sympathetic stimulation in the presence of acetylcholine confirming that gallamine inhibits the prejunctional effect of the latter on adrenergic transmission. When extrapolated to the intact organism, the present experiments indicate that gallamine and pancuronium augment the release of norepinephrine in vascular tissue under vagal control, which explains in part the cardiovascular effects of these muscle relaxants.

Acetylcholine↗
PubMed1979

Pancuronium bromide precurarisation. II An evaluation of clinical aspects in patients of female sex.

The authors have studied the effects of precurarisation by means of pancuronium on 120 female patients by using three multiple doses of pancuronium bromide. The authors have demonstrated that the dose of pancuronium, capable of abolishing almost completely fasciculations and postoperative succinylcholine myalgias, corresponds to 0.009 mg/kg. This dose has proved to be most efficient in causing a considerable increase in subjective precurarisation symptoms (Heavy eye-lids, blurred vision etc.). Such symptoms have never caused even the least discomfort to the patients. The authors have finally demonstrated that the doses of pancuronium employed cause a decrease in V.C. within limits that do not, however, compromise ventilation.

Adult↗
PubMed1982

Clinical use of vecuronium (ORG NC 45) in balanced anesthesia. Comparison with pancuronium.

In 2 groups of 25 patients 0.1 mg/kg vecuronium (Org NC 45) or pancuronium, according to a randomised basis, was injected during balanced anesthesia (thiopental, fentanyl, dehydrobenzperidol and N2O). Intubation conditions 120 seconds after injection were satisfactory. After intubation, a heart rate increase was present with pancuronium (p less than 0.01), but not with vecuronium (difference: p less than 0.05); heartrate decreased 15 and 30 minutes after injection of vecuronium (p less than 0.01). The clinical duration of action of vecuronium was 32.7 +/- 2.4 min (Mean +/- SEM) and of pancuronium 73.5 +/- 4.8 min (p less than 0.01). Successive maintenance doses of 0.025 mg/kg of vecuronium had a duration of action of 23.1 +/- 1.7, 26.8 +/- 2.1, 27.6 +/- 4.0 and 24.0 +/- 2.8 min (diff. NS), showing no cumulative activity. The duration of action of identical doses of pancuronium were 56.9 +/- 3.1, 52.1 +/- 7.2 and 61.3 +/- 17.6 min (diff. NS), values nearly +/- 220% above those of vecuronium (p less than 0.01). Reversion of neuromuscular blockade after vecuronium with small amounts of neostigmine was clinically adequate.

Adult↗
PubMed1984

[Comparative clinical studies of vecuronium, atracurium and pancuronium].

The new relaxants vecuronium (Norcuron) and atracurium (Tracrium) have been compared with pancuronium (Pavulon) with respect to onset and duration of action and intubating conditions under clinical situations. A variant of the balanced anaesthesia technique with flunitrazepam, fentanyl and N2O/O2 was used. The following doses were considered equipotent (mg/kg body weight): vecuronium 0.07/0.10; atracurium 0.35/0.50; pancuronium 0.08/0.115. The degree of neuromuscular block was assessed in a semiquantitative manner, using the train of four. No difference between the three relaxants in onset of action was found. After the high doses, however, full paralysis developed 60 s earlier. The same is true of intubating conditions. Good or very good intubating conditions were obtained in the majority of cases 3 minutes after injection of the drug. Following the higher dose, good intubating conditions are achieved approximatively 1/2-1 min sooner. Both new relaxants allow for relatively rapid intubation without the inconvenience of a long duration of action. After a low initial dose the following time for recovery to 25% was noted (means +/- S.D., min): vecuronium 20.3 +/- 7.0; atracurium 28.0 +/- 3.1; pancuronium 53.3 +/- 14.8. The early recovery phase (from 5% to 25% recovery) was 6.1 +/- 2.4 after vecuronium, 8.3 +/- 1.7 after atracurium, 17.2 +/- 10.8 after pancuronium. There is a good correlation between our semiquantitative results, using the train of four, and quantitative recordings of muscle contractions reported in the literature. Both drugs show no cumulative effect after five repeated administrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Comparative clinical studies on vecuronium, atracurium and pancuronium in older patients].

The relaxants vecuronium (Norcuron), atracurium (Tracrium), and pancuronium (Pavulon) have been investigated with respect to onset and duration of action in old patients compared with young patients. A variant of a balanced anaesthesia technique with flunitrazepam, fentanyl and N2O/O2 was used. The following equipotent doses were investigated (mg/kg body weight): vecuronium 0.07/0.10; atracurium 0.35/0.50; pancuronium 0.08/0.115. The neuromuscular function was assessed in a semiquantitative manner with the Train-of-Four (TOF). We found a trend to a delayed onset of action in old patients. This effect, however, reached a significant level with pancuronium only. The degree of relaxation after comparable doses was less after atracurium in old patients. This difference between young and old patients could not be observed after vecuronium and was hardly detectable after pancuronium. The duration of action to a 25% recovery and the early recovery phase from the appearance of the first to the fourth twitch in the TOF showed no difference between young and old patients. It is concluded that there are no considerable differences with respect to the duration of action between young and old patients. However, to obtain a similar degree of relaxation, it is recommended to use a somewhat higher dose level with atracurium.

Adolescent↗
PubMed1980

Comparative clinical study of pipecurium bromide and pancuronium bromide.

The properties and the effects of a new steroid muscle relaxant preparation 2 beta,16 beta-bis(4'-dimethyl-1'-piperazino)-3 alpha,17 beta-diacetoxy-5 alpha-androstane dibromide (pipecurium bromide, RGH-1106, Arduan) were compared to those of pancuronium bromide in a controlled randomized clinicopharmacological study using ataranalgesic anaesthesiological technique. In 45 cases pipecurium bromide, in other 45 cases pancuronium bromide was used as long-acting muscle relaxant in anaesthesia for general surgical procedures. According to the results, pipecurium bromide is approximately 20% more potent than pancuronium bromide, it induces mechanical response characteristic for non-depolarizing muscle relaxants, and the residual neuromuscular blockade can be antagonized completely by neostigmine. There were no ECG alterations or specific serum enzyme (CPK, GOT. LDH) level changes observed. Pipecurium bromide did not influence blood pressure but in contrast to the heart rate increasing effect of pancuronium bromide, it caused mild bradycardia. On the basis of the study the drug can be used for further wide scale clinical investigations.

Androstane-3,17-diol↗
PubMed1983

Comparison of thiopental and midazolam on the neuromuscular responses to succinylcholine or pancuronium in humans.

Midazolam (0.3 mg/kg) was compared to thiopental (4.0 mg/kg) for possible interactions with succinylcholine or pancuronium when used for induction of anesthesia. Neuromuscular function was monitored by recording the force of thumb adduction in response to ulnar nerve stimulation. Following induction of anesthesia with either midazolam (N = 10) or thiopental (N = 10), stable muscle-twitch tension was obtained and succinylcholine (1 mg/kg) was given intravenously. The duration of blockade, recovery time, intensity of fasciculations, or adequacy of relaxation for tracheal intubation did not differ between patients receiving midazolam or thiopental. An additional group of patients anesthetized and monitored in the same manner received pancuronium (0.025 mg/kg) in incremental doses until a 99% depression of muscle-twitch tension was obtained. Dose-response curves for pancuronium, duration of blockade, and adequacy of relaxation for tracheal intubation did not differ between patients receiving midazolam (N = 10) or thiopental (N = 10). We conclude that the neuromuscular blockade produced by succinylcholine or pancuronium was no different in patients receiving either midazolam or thiopental for induction of anesthesia.

Anesthesia, Intravenous↗
PubMed1980

Pulmonary function following 'pretreatment' dose of pancuronium in volunteers.

The effect of a pretreatment dose (0.014 mg/kg) of pancuronium bromide on pulmonary function tests in 15 healthy volunteers was investigated. Ventilatory flow volume loops and maximum voluntary ventilation were determined before and 1 and 3 minutes following administration of the pancuronium. Calculation of the pulmonary function from the flow volume loops revealed statistically significant decreases in forced expiratory flow at 50% of expired volume, forced expiratory volume at 1 second and 3 seconds, peak inspiratory flow, peak inspiratory flow at 50% of inspired volume, forced vital capacity, and maximum voluntary ventilation. Significant pulmonary dysfunction associated with dyspnea was seen in four subjects and one subject had to be artificially ventilated and pancuronium had to be reversed with prostigmine. Ventilation should be closely monitored in patients following pretreatment doses of pancuronium in view of frequent atypical responses.

Adult↗
PubMed1994

Circulatory drugs modify the hemodynamic actions of alfentanil combined with vecuronium or pancuronium.

To verify, whether drugs used to treat hypertension, coronary disease, and heart insufficiency modify the hemodynamic effects of the combinations alfentanil-vecuronium and alfentanil-pancuronium, 36 patients taking these drugs (most often beta-adrenergic antagonists) were randomized to receive either vecuronium or pancuronium in connection with ophthalmic surgery. In comparison with healthy patients, the heart rate and arterial pressure changes during induction, intubation and surgery appeared to be smoothed. Heart rate and arterial pressure equaled between the study groups, indicating a block of the sympathomimetic actions of pancuronium. One third of the patients receiving vecuronium exhibited nodal rhythm and some of them showed slow heart rates during intense surgical stimulation. Pancuronium offered protection against bradyarrhythmias.

Aged↗
PubMed1993

[A comparison of pancuronium and vecuronium used during the induction of high-dose fentanyl anesthesia].

Effects on hemodynamics and blood catecholamine levels of pancuronium and vecuronium used during the induction of anesthesia, were studied in patients undergoing coronary artery bypass grafting. Anesthesia was induced out with fentanyl, 70 micrograms.kg-1, and diazepam, 0.2 mg.kg-1, and either pancuronium or vecuronium was administered in a dose of 0.2 mg.kg-1. Control measurements were made before the induction of anesthesia. Hemodynamic parameters and blood levels of norepinephrine (NEP) and epinephrine (EP) were measured three minutes (S1) and ten minutes (S2) after tracheal intubation. The study showed that HR, AP, CI, and coronary perfusing pressure were more stable in the group of patients receiving pancuronium (group P) than in the group receiving vecuronium (group V) during the induction of anesthesia. LVSWI and RVSWI showed a comparable decline in both groups. While NEP was unaffected in group P during the induction of anesthesia, it decreased significantly at S1 and S2, compared with control (S0), in group V. On the other hand, EP decreased significantly at S1 and S2 during the induction of anesthesia in both groups, but group V showed a greater change. The results of this study suggest that pancuronium is more advantageous than vecuronium as a muscle relaxant used during the induction of high-dose fentanyl anesthesia.

Anesthesia, Inhalation↗
PubMed1996

[The pharmacokinetics of pancuronium bromide in infants, children and adults].

Twenty-four patients scheduled for elective plastic surgery were selected to study the pharmacokinetics of pancuronium bromide under enflurane anesthesia. The patients were divided into three groups by their ages; Group 1 consisted of 5 infants (0.75-2.95 years); Group 2 contained 13 children (4-14 years); Group 3 included 6 adults (16-27 years). An improved fluorimetric assay was used to measure the plasma concentrations of pancuronium bromide after administration of pancuronium bromide at a dose of 100 micrograms/kg. The results showed that the disposition of pancuronium bromide may be best described mathematically by a two-compartment open model in all patients. The younger the patients, the larger the distribution volumes and the higher the Cl. There were significant differences among the three groups with regard to V1, V2, Vdss, Cl, AUC. The T1/2 beta and MRT were longer in Group 1 than in Group 2 and Group 3.

Adolescent↗
PubMed2000

A case of suicide by intravenous injection of pancuronium.

This report details a suicide by pancuronium bromide injection by a 31-year old female anesthesiologist. Pancuronium bromide was identified in the blood and brain by means of ion-pair extraction followed by thin-layer chromatography, spectrophotometry and electrospray ionization/tandem mass spectrometry. After this positive identification, the levels of pancuronium were carefully quantified by spectrophotometry: 1.05 mg/ml in the blood and 0.51 mg/g in the brain. The cause of death was judged to be asphyxia due to respiratory muscle paralysis caused by pancuronium.

Journal Article↗
PubMed1998

Respiratory function and extraocular muscle paralysis following administration of pancuronium bromide in dogs.

Pancuronium bromide, a neuromuscular blocking agent, was evaluated in canine cataract surgical patients under general anesthesia to determine its effects on respiratory function and globe position. Two paralytic, anesthetic regimes were studied: one using a standard dosage of 0.066 mg kg-1 pancuronium bromide, given intravenously while providing the patient with ventilatory support, and one using a dosage of 0.022 mg kg-1 in which no ventilatory support was provided. Eye position and anterior vitreal position/displacement were recorded by a surgeon who was blinded as to treatment group. Physiological parameters indicative of respiratory function were monitored. Both dosages of pancuronium produced comparable, neutral globe position within 30 s following administration which lasted for 20-30 min. All patients in the standard dose group experienced uneventful anesthetic episodes with physiological parameters well within the normal ranges. Within 5 min after administration, all patients in the low-dose group developed a pronounced respiratory acidosis (mean arterial pH = 7.07 +/- 0.08; mean PaCO2 = 79.8 +/- 10.7 mmHg), which exceeded a set of predetermined safety limits, and subsequently these dogs received ventilatory support. We conclude that 0.022 mg kg-1 pancuronium rapidly produces an unacceptable level of respiratory acidosis and, as a result, patients receiving neuromuscular blocking agents should routinely receive ventilatory support.

Journal Article↗
PubMed1976

Early and late relative potencies of pancuronium and d-tubocurarine in man.

In ten patients anesthetized with halothane and nitrous oxide, d-tubocurarine or pancuronium was infused continuously for 80 minutes to produce a constant 90 per cent depression of twitch tension. For the first 30-minutes period, 8.2 +/- 0.32 and 1.09 +/- 0.06 (mean +/- SE) mg/m2 of d-tubocurarine or pancuronium, respectively, were required, and for the last 30-minutes period (50 to 80 minutes of infusion) 2.1 +/- 10.10 and 0.41 +/- 0.02 mg/m2 were required, giving potency ratios of 8.2/1.1, i.e., 7.4, and 2.1/0.41, i.e., 5.1. The difference in potency ratios in the first and last 30-minutes periods implies that potency values determined by single-injection techniques inadequately describe the relative requirements for sustained paralysis. The mean ratios between that amount of relaxant representing tissue uptake and that amount representing metabolism and renal excretion during the first 30 minutes were 3.06 +/- 0.28 for d-tubocurarine and 1.63 +/- 0.19 for pancuronium. The significantly higher ratio for d-tubocurarine implies that its tissue uptake relative to metabolism and renal excretion is greater than that for pancuronium. The higher ratio for d-tubocurarine may be partly explained by its greater binding to plasma and tissue proteins.

Adult↗