Phenytoin-induced resistance to pancuronium. Use of atracurium infusion in management of a neurosurgical patient.
A case report is presented of a patient receiving chronic phenytoin therapy who demonstrated resistance to pancuronium by increased hourly requirements. Stable neuromuscular blockade was achieved by atracurium infusion at normal rates. Possible explanations for the differences in response to the two non-depolarizing muscle relaxants are discussed.
Hickey
D R
DR
Department of Anesthesia, McGill University, Royal Victoria Hospital, Montreal, Quebec, Canada.
Sangwan
S
S
Bevan
J C
JC
D000293:Adolescent; D001279:Atracurium / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000601:surgery; D004347:Drug Interactions; D004361:Drug Tolerance; D004827:Epilepsy / Q000188:drug therapy; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010197:Pancuronium / Q000037:antagonists & inhibitors*; D010296:Parietal Lobe / Q000601:surgery; D010672:Phenytoin / Q000494:pharmacology* / Q000627:therapeutic use
D001279:Atracurium; D010672:Phenytoin; D010197:Pancuronium