Prolonged paralysis associated with long-term pancuronium use

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