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Pancuronium Bromide Side Effects

L. R. Beam, MD
JAMA. 1973;223(9):1044. doi:10.1001/jama.1973.03220090064028.
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To the Editor.—  Pancuronium bromide, a new muscle relaxant used mostly in surgical procedures the past five years, was recently administered for status asthmaticus (222:1265, 1972). This report, others, and the package insert indicate insignificant cardiovascular effects with the use of pancuronium. Yet other reports are contrary, the controversy being unresolved probably due to varying experimental conditions.1-4 On Dec 6, 1972, we administered 4 mg of pancuronium bromide (0.2 mg/kg) to a 7-yearold, 22-kg boy with status asthmaticus and respiratory failure treated by controlled respiration. Within three minutes the heart rate, monitored by telemetry and confirmed clinically, increased from 150 to 210 beats per minute, not stabilizing at or below the prepancuronium rate for 17 hours. Increment doses of 2 mg were required hourly through 19 hours, then reduced to 1 mg or less. The patient recovered without apparent complication after 55 hours of controlled respiration. We believe it


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