Pancuronium Bromide as the Sole Muscle Relaxant for Major Surgery

Intravenous pancuronium bromide in an initial dose of 0.1 mg./kg. and increments of 0.02 mg./ kg. was found effective and predictable as the sole muscle relaxant in 125 adults undergoing major abdominal or thoracic surgical procedures under nitrous oxide (N20)-oxygen (O2) -fentanyl anesthesia. Dose-response relationships, as judged by duration of relaxation using a peripheral nerve stimutor, were unaffected by age. Intubation was found satisfactory in all age groups at either 3 or 5 minutes after pancuronium administration. Reversal of neuromuscular blockade was complete and predictable in all patients; however, the shortest duration of anesthesia in this study was 55 minutes. It is concluded that pancuronium bromide (0.1 mg./kg.) should provide a valuable alternative to d-tubocurarine for intubation and subsequent relaxation in adults from 18 to 86 years of age. Findings were consonant with the hypothesis that a depolarizing muscle relaxant need not be used with pancuroninum.