PANCURONIUM

Pancuronium bromide received FDA approval on 24 October 1972 for use as a skeletal muscle relaxant during surgical procedures.

Pancuronium is administered as an adjuvant to general anesthesia to prepare you for surgery. This medication assists in maintaining your body still by relaxing your skeletal muscles during the surgical procedure. It also facilitates the relaxation of the throat, making inserting a breathing tube (endotracheal intubation) easier before surgery. This medication is used as a muscle relaxant in almost all age groups, including adults, adolescents (2-17 years), newborns, and infants (0 days – 23 months). It is also employed to aid in emergency airway management (mechanical ventilation) for patients in intensive care.

Pancuronium is available as a 4mg injection. It is given intravenously (into a vein), either as single injections or as a continuous infusion (a drip) by your healthcare provider. Your physician will decide the dosage of this injection based on the severity of your disease and other factors.

Pancuronium can cause some side effects like any other drug. If any side effects occur while you are under anaesthesia, they will be seen and treated by your doctor. Some of the serious side effects are prolonged paralysis (seen in long-term use), bronchospasm/respiratory depression (difficulty breathing), apnea (when you stop breathing), and anaphylaxis (sudden allergic reactions). Seek medical attention immediately if any of these side effects occur. Some of the common side effects are injection site pain and muscle weakness.

Before receiving pancuronium, it is crucial to discuss the following with your healthcare team: any prior allergies to pancuronium or other muscle relaxants, reduced renal function or renal disease, heart or circulatory conditions, fluid accumulation, liver or gallbladder issues, edema (swelling of ankles), diseases affecting nerves and muscles such as polio, myasthenia gravis or Eaton-Lambert syndrome. Transparent communication about your medical history is essential for a safe and effective treatment plan.

Inform your doctor if you are pregnant or breastfeeding before the treatment. Do not drive or use heavy machinery until you are told okay since pancuronium bromide might make you weak or dizzy. Your anesthesia doctor will tell you when it is safe to resume these activities and how long these feelings might last.

Pancuronium is administered exclusively in hospital settings by your doctor during surgical procedures. Your doctor will provide continuous monitoring while you receive pancuronium to assess its effects. This injection causes muscle relaxation, including the muscles involved in breathing. As a result, you will require assisted breathing (artificial ventilation) during and after your surgery until you are able to breathe independently. If you have any concerns or questions about this medication, discuss them with your doctor prior to administration.

Organon inc, US Food and Drug Administration (FDA), [Accessed on 17th Oct 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/017015s023lbl.pdf Pfizer, [Revised on Jan 2019] [Accessed on 17th Oct 2023] https://www.pfizer.com/products/product-detail/pancuronium_bromide KD Tripathi, Essentials of Medical Pharmacology, Skeletal muscle relaxants, 8th edition, 2019, 379 Goodman & Gilman’s, The Pharmacological Basis of Therapeutics, Agents acting at the neuromuscular junction and autonomic ganglia, 13th edition, 2018, 180