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Pancuronium bromide induced joint contractures in the newborn
Archives of Disease in Childhood
|January 1, 1984
Insights
Pancuronium bromide, used with mechanical ventilation, may cause joint contractures in infants. Drug interactions with gentamicin and phenobarbitone, or pre-existing conditions, might increase this risk.
Area of Science:
- Neonatal care
- Pediatric pharmacology
- Neuromuscular blockade
Background:
- Mechanical ventilation is a critical support for critically ill infants.
- Pancuronium bromide is a neuromuscular blocking agent used to facilitate mechanical ventilation.
- Understanding potential adverse effects of medications in neonates is crucial.
Observation:
- Three infants receiving pancuronium bromide for mechanical ventilation developed multiple joint contractures.
- Two term infants also received gentamicin and phenobarbitone concurrently.
- One preterm infant had pre-existing contractures that worsened post-paralysis.
Findings:
- Pancuronium bromide administration in infants may be associated with the development of joint contractures.
- Concomitant use of gentamicin and phenobarbitone might potentiate pancuronium bromide's effects, increasing contracture risk.
- Pre-existing joint contractures can be exacerbated by pancuronium bromide therapy.
Implications:
- Clinicians should be vigilant for joint contractures in infants treated with pancuronium bromide.
- Potential drug interactions with pancuronium bromide in neonates require careful consideration.
- Further research is needed to elucidate the mechanisms and risk factors for pancuronium-induced contractures.
Abstract:
We report three infants paralysed with pancuronium bromide as an adjunct to mechanical ventilation, who developed multiple joint contractures. In two term infants, gentamicin and phenobarbitone given together with pancuronium may have potentiated its effect, and in one preterm infant contractures, which became more severe after paralysis, were present at birth.