Pancuronium bromide

Reviewed by Dr Carl Kuschel and Brenda Hughes
February 2001
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page

Management of Pancuronium Bromide Administration




Slow IV Injection

  1. Further dilution not required.
  2. Filter prior to administration through a Pall 0.2 micron filter.
  3. Administer by slow IV injection over 1 minute.
  4. Compatible with NS and D5W. Also compatible with heparin.
  5. Do NOT mix with other drugs, IV solutions, blood, or blood products.
  6. Flush line with NS before and after injection of pancuronium.

Observation and Documentation

  1. Administer only to intubated babies.
  2. Observe for signs of adverse reactions.
  3. Use comfort measures, sedatives, and analgesics as indicated (does NOT alter pain threshold).
  4. Careful positioning and changes of position. Nurse baby on sheepskin.
  5. Monitor oxygenation with blood gases and pulse oximetry.
  6. Careful clinical observation. Pancuronium limits ability to assess the baby.
  7. Provide eye protection PRN.
  8. Monitor fluid balance.
  9. Careful airway care to remove secretions.
  10. Express bladder PRN.
  11. Keep resuscitation equipment near bedside.


Selected References

1 Costarino AT, Polen RA. Neuromuscular relaxants in the neonate. Clin Perinatol 1987; 14:965.
2 Cabal LA, Siassi B, Artal R, et al. Cardiovascular and catecholamine changes after administration of pancuronium in distressed neonates. Pediatr 1985; 75:284.
3 Bhutani VK, Abbasi S, Sivieri EM. Continuous skeletal muscle paralysis: effects on neonatal pulmonary mechanics. Pediatr 1988; 81:419.