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Diverse range of fixed positional deformities and bone growth restraint provoked by flaccid paralysis in embryonic
Katherine J Lamb1, Jo C Lewthwaite, Jean-Pierre Lin
1Department of Veterinary Basic Sciences, The Royal Veterinary College, Royal College Street, London, UK.
Insights
Pancuronium bromide (PB) causes skeletal deformities and growth reduction in chick embryos. This suggests potential risks for fetuses and neonates receiving this neuromuscular blocking drug.
Area of Science:
- Developmental Biology
- Pharmacology
- Orthopedics
Background:
- Pancuronium bromide (PB) is a non-depolarizing neuromuscular blocking drug used in neonates and pregnant women for mechanical ventilation.
- These drugs are administered to approximately 0.1% of human births in the UK.
Purpose of the Study:
- To investigate the effects of pancuronium bromide on skeletal development in chick embryos.
- To assess the impact of pharmacologically induced flaccid immobility on embryonic skeletal growth and morphology.
Main Methods:
- Administration of pancuronium bromide to chick embryos during development.
- Analysis of skeletal elements, cartilage-to-bone ratios, joint morphology, and growth patterns.
Main Results:
- PB treatment resulted in significant skeletal deformities and reduced longitudinal growth of appendicular elements.
- Increased cartilage to bone ratios indicated reduced osteogenesis.
- Elevated incidence of knee joint flexion and tibiotarsal joint hyperextension was observed.
Conclusions:
- Pharmacologically induced flaccid immobility via PB negatively impacts embryonic skeletal development.
- Findings suggest potential implications for human fetuses and neonates exposed to PB, particularly concerning skeletal development.
Abstract:
Pancuronium bromide (PB) is used in neonates and pregnant women to induce limp, flaccid paralysis in order to allow mechanical ventilation during intensive care. Such non-depolarizing neuromuscular blocking drugs are administered to 0.1% of all human births in the UK. In this study, we examined PB effects on skeletal development in chick embryos. PB treatment produced skeletal deformities associated with significant reduction in longitudinal growth of all appendicular elements. This was associated with greater cartilage to bone ratios, indicating a preferential reduction in osteogenesis. PB also increased the incidence of knee joint flexion and tibiotarsal joint hyperextension. In addition to limb, spinal and craniofacial deformities, flaccid immobility appears to convert the normal geometric pattern of weight gain to a simple arithmetic accretion. This novel study highlights the potentially harmful effects of pharmacologically induced flaccid immobility on chick embryonic skeletal development. Whilst in ovo avian development clearly differs from human, our findings may have implications for the fetus, premature and term neonate receiving such non-depolarizing neuromuscular blocking drugs.
