Pancuronium bromide (Pavulon)

Category:

  • Muscle relaxant

Description:

  • Nondepolarizing skeletal muscle relaxant

Indications:

  • Adjunct to general anesthesia to facilitate intubation and skeletal muscle relaxation

  • Maintenance of muscle relaxation in patients undergoing mechanical ventilation

Contraindications:

Precautions:

  • Pregnancy category C

  • Only used by skilled personnel in airway management and respiratory support.

  • Use with caution in patients with myasthenia gravis due to profound effects to small doses.

  • Must have anticholinesterase reversal agents immediately available during use.

  • Use with caution in patients with hepatic or biliary tract disease due to decreased medication clearance.

  • Contains benzyl alcohol that may cause “gasping syndrome” in premature infants.

  • Use with caution is severely obese patients or neuromuscular disease.

  • The intensity and duration of pancuronium activity is enhanced by potent inhalation agents and succinylcholine.

  Adverse Reactions (Side Effects):

  • Neuromuscular: extension of action beyond completion of surgery

  • Cardiovascular: tachycardia, increased arterial pressure, increased cardiac output

  • Dermatologic: transient rash

  • Increased salivation during anesthesia

Dosage:

  • Administered via IV injection

  • Bolus:

    • Initial adult dose: 0.04-0.1mg/kg IV bolus

    • Maintenance doses start at 0.01mg/kg

    • Endotracheal intubation: 0.06-0.1mg/kg bolus dose, intubation usually in 2-3 minutes

  • Pediatric dose:

    • Children: no adjustments needed

    • Neonates: give test dose of 0.02mg/kg to check responsiveness

    • Children 1 month – 2 years old: 0.3-0.4mg/kg

 
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