Prolonged Paralysis Associated with Long‐Term Pancuronium Use

Janet L. Haas, Mark S. Shaefer, Linda J. Miwa, R. Patrick Wood, Byers Wendell Shaw Jr

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

We cared for a 4‐year‐old patient who had undergone orthotopic liver transplantation and was placed on a ventilator for respiratory distress associated with Pneumocystis carinii pneumonia. The neuromuscular blocking agent pancuronium bromide 1.0–1.2 mg every hour as needed was used to facilitate artificial ventilation for 40 days. On discontinuation of pancuronium, the patient experienced severe, generalized neuromuscular dysfunction. Because no improvement was seen for 2 weeks, the acetylcholinesterase inhibitors edrophonium and pyridostigmine were instituted. Shortly thereafter the patient's condition began to improve. Gradual improvement occurred over 3–4 months and the patient has since returned to baseline neurologic function. We suggest that long‐term pancuronium use was the cause of the patient's prolonged paralysis. The improvement experienced after the initiation of antidotal therapy strongly supports our proposal. 1989 Pharmacotherapy Publications Inc.

Original languageEnglish (US)
Pages (from-to)154-157
Number of pages4
JournalPharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Volume9
Issue number3
DOIs
StatePublished - Jan 1 1989

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Pancuronium
Paralysis
Edrophonium
Pyridostigmine Bromide
Neuromuscular Blocking Agents
Pneumocystis Pneumonia
Cholinesterase Inhibitors
Mechanical Ventilators
Liver Transplantation
Nervous System
Publications
Drug Therapy

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Prolonged Paralysis Associated with Long‐Term Pancuronium Use. / Haas, Janet L.; Shaefer, Mark S.; Miwa, Linda J.; Wood, R. Patrick; Shaw Jr, Byers Wendell.

In: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, Vol. 9, No. 3, 01.01.1989, p. 154-157.

Research output: Contribution to journalArticle

Haas, Janet L. ; Shaefer, Mark S. ; Miwa, Linda J. ; Wood, R. Patrick ; Shaw Jr, Byers Wendell. / Prolonged Paralysis Associated with Long‐Term Pancuronium Use. In: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 1989 ; Vol. 9, No. 3. pp. 154-157.
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