Plasma Concentrations of Pancuronium and Neuromuscular Blockade after Injection into the Isolated Arm, Bolus Injection, and Continuous Infusion

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Abstract
To establish whether the plasma concentration of pancuronium reflects magnitude of neuromuscular blockade, the recovery times from neuromuscular blockade and associated plasma concentrations after equipotent doses of pancuronium using 3 methods of pancuronium administration: the isolated-arm technique in conscious volunteers (n = 4), the bolus i.v. injection (n = 7) and continuous-infusion methods (n = 3) in anesthetized patients were determined. Maximum depressions of twitch tension were similar (85 .+-. 11, 91 .+-. 6 and 92 .+-. 4%, respectively) with the 3 techniques. Recovery times from neuromuscular blockade differed significantly, being 10 .+-. 2 min with the isolated-arm technique, 23 .+-. 7 min with the bolus-injection technique, and 46 .+-. 5 min with the continuous-infusion method. The plasma concentration of pancuronium necessary for neuromuscular blockade was least with the isolated-arm technique and greatest with continuous infusion. At 25 and 75% recovery, mean plasma concentrations were 0.07 .+-. 0.01 and 0.04 .+-. 0.01 .mu.g/ml in the isolated arm, 0.13 .+-. 0.04 and 0.09 .+-. 0.02 .mu.g/ml after bolus injection, and 0.20 .+-. 0.04 and 0.11 .+-. 0.01 .mu.g/ml during continuous infusion, respectively. Apparently the relationship between plasma concentration of pancuronium and magnitude of neuromuscular blockade depends on the method of pancuronium administration.

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