Clinical evaluation of a new muscle relaxant, pancuronium bromide.

Our findings deserve the following conclusions.1) With an initial dose of 0.1 to 0.15 mg/kg, sufficient and excellent muscular relaxation for endotracheal intubation can be obtained within 2 - 5 minutes after intravenous administration of pancuronium bromide in man.2) A large dose of 3 mg/kg in total was used to maintain controlled respiration under moderate hypothermia to treat a 6 year-old boy who had general convulsion and muscular twitching which accidentally occurred postoperatively after open heart surgery for ASD. In reference to this case, we noted none of the untoward reactions like tachyphylaxis or cumulative action and none of the untoward responses in the cardiovascular system.3) We did not experience the prolonged apnea which lasted more than two hours although a relatively large dose of pancuronium bromide had been used.4) Anti-hypotensive action was noticed on the hypotension due to halothane anesthesia, possibly with reference to the steroid type of chemical structure as suggested by Bonta.5) The preoperative complications such as mal-nutrition, anemia and renal impairment in cancer patients deserve special attention, that is, a larger dose should be avoided.Obviously much more clinical investigations about the effects of pancuronium as a neuromuscular blocker should be required before further precise conclusions can be drawn.