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British Journal of Anaesthesia, 1981, Vol. 53, No. 12 1303-1309
© 1981 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

RECOVERY FROM PANCURONIUM BLOCKADE IN THE NEONATAL INTENSIVE CARE UNIT

N. G. GOUDSOUZIAN, M.D., R. K. CRONE, M.D. and I. D. TODRES, M.D.

Anesthesia and Children's Services of the Massachusetts General Hospital and the Departments of Anaesthesia and Pediatrics at the Harvard Medical School

Correspondence to: N. G. G., Department of Anesthesia, Massachusetts General Hospital, Boston, MA 02114, U.S.A.

Neuromuscular blockade with pancuronium and its antagonism was evaluated in 33 critically ill infants. The evoked contraction of the adductor pollicis from indirect stimulation of the ulnar nerve was measured. The neuromuscular blockade recovered spontaneously from pancuronium in seven infants, 23 required one or more doses of atropine 0.02 ng kg–1 and neostigmine 0.06mg kg–1. In three infants the blockade railed to reverse. Immature infants less than 32 weeks did not show any significant difference in their requirement for pancuronium compared with mature infants. Age and birth weight of the infant, dose of pancuronium and duration of its administration did not affect the requirements for reversal. Train-of-four and tetanus:twitch ratios were lower (P<0.05) in infants less than 32 weeks of developmental age reflecting immaturity of neuromuscular transmission.


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