PANCURONIUM INCREASES PULMONARY ARTERIAL-PRESSURE IN LUNG INJURY

We studied 25 mongrel dogs who were anaesthetized and their lungs vent ilated for investigation of the effects of pancuronium on pulmonary ar terial pressure (PAP) in the normal lung, in oleic acid-induced lung i njury and in lung injury with hypoxaemia. in the normal lung, PAP was not affected by pancuronium. During lung injury, however, PAP was incr eased from 21.5 (SD 2.8) to 24.6 (4.2) mm Hg (P<0.01) and from 22.0 (4 .2) to 27.0 (5.8) mm Hg (P<0.01) after pancuronium 0.08 mg kg(-1) and 0.16 mg kg(-1), respectively, and from 26.0 (2.9) to 37.1 (3.1) mm Hg after pancuronium 0.16 mg kg(-1) when hypoxaemia was present (P<0.01). The increase in PAP induced by pancuronium was associated with increa ses in cardiac output and pulmonary vascular resistance. Pretreatment with pentolamine attenuated the pancuronium-induced increase in PAP. T he increase in PAP induced by pancuronium was also reduced by vagotomy . If these results in dogs are relevant clinically, then pancuronium s hould be avoided as a neuromuscular blocker in lung injury.