Pancuronium in caesarean section and its placental transfer

Pancuronium bromide was used in 49 patients undergoing repeat elective Caesarean section. In 26 patients who received only pancuronium 0.1 mg kg-1, pancuronium was detected in all umbilical venous or arterial samples (0.12 micrograms ml-1). In 23 other patiets who received suxamethonium 1.0 mg kg-1 followed by pancuronium 0.05 mg kg-1, pancuronium was detected in fetal blood 2 min after injection; the concentration of pancuronium in umbilical venous or arterial samples in 14 subjects was 0.08 micrograms ml-1, and less than 0.05 micrograms ml-1 in nine subjects. There was no evidence that such concentrations of pancuronium were detrimental to the fetus. The use of suxamethonium before pancuronium resulted in reduction of pancuronium dosage, induction-delivery time, and fetal concentrations of pancuronium, and was associated with better condition of the neonate.