Understanding Anesthesiology - The Global Regional Anesthesia ...

Pancuronium
Class
Nondepolarizing skeletal muscle relaxant (NDMR); long-acting
Mechanism of Action
Competitive inhibitor at the acetylcholine receptors of the post-synaptic cleft of the neuromuscular
junction.
Dose
Intubation: 0.1 mg/kg IV
Maintenance bolus: 0.01-0.03 mg/kg
Onset
4-5 minutes
Duration
45-65 minutes
Elimination
Renal (80%), hepatic (minor)
Effects
CVS
Pancuronium has a vagolytic effect and therefore causes tachycardia and hypertension. Increased
risk of arrhythmias in patients receiving tricyclic antidepressants and volatile anesthetics.
Respiratory
May promote bronchospasm, salivation.
MSK
The neuromuscular blockade effects of non-depolarizing muscle relaxants are potentiated by
succinylcholine, volatile anesthetics, aminoglycosides, lithium, loop diuretics, lidocaine, magnesium,
lithium, ganglionic blockers, hypothermia, hypokalemia and respiratory acidosis. Enhanced
neuromuscular blockade is seen in patients with myasthenia gravis or myopathies.
The effects of NDMR are antagonized by cholinesterase inhibitors. Increased resistance to
NDMR is seen in patients on theophylline, burn patients and those with paresis or paralysis.
Misc.
Muscle relaxants are the most common cause of anaphylactoid reactions under general anesthesia.
Related Glossary Terms
Anticholinesterase, Atracurium, Cis-Atracurium, Neuromuscular junction, Non-depolarizing
muscle relaxants, Peripheral nerve stimulator, Residual block, Rocuronium, Vagolytic
Index
Find Term
Chapter 3 - General Anesthesia
Chapter 6 - Drug Finder
Chapter 6 - Muscle Relaxants