Prolonged paralysis associated with long-term pancuronium use.

Abstract:

:We cared for a 4-year-old patient who had undergone orthotopic liver transplantation and was placed on a ventilator for respiratory distress associated with Pneumocystis carinii pneumonia. The neuromuscular blocking agent pancuronium bromide 1.0-1.2 mg every hour as needed was used to facilitate artificial ventilation for 40 days. On discontinuation of pancuronium, the patient experienced severe, generalized neuromuscular dysfunction. Because no improvement was seen for 2 weeks, the acetylcholinesterase inhibitors edrophonium and pyridostigmine were instituted. Shortly thereafter the patient's condition began to improve. Gradual improvement occurred over 3-4 months and the patient has since returned to baseline neurologic function. We suggest that long-term pancuronium use was the cause of the patient's prolonged paralysis. The improvement experienced after the initiation of antidotal therapy strongly supports our proposal.

journal_name

Pharmacotherapy

journal_title

Pharmacotherapy

authors

Haas JL,Shaefer MS,Miwa LJ,Wood RP,Shaw BW Jr

doi

10.1002/j.1875-9114.1989.tb04121.x

subject

Has Abstract

pub_date

1989-01-01 00:00:00

pages

154-7

issue

3

eissn

0277-0008

issn

1875-9114

journal_volume

9

pub_type

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