pancuronium and Pain

The physiology and pathology of different methods of capital punishment are described. Information about this physiology and pathology can be derived from observations on the condemned persons, postmortem examinations, physiological studies on animals undergoing similar procedures, and the literature on emergency medicine. It is difficult to know how much pain the person being executed feels or for how long, because many of the signs of pain are obscured by the procedure or by physical restraints, but one can identify those steps which are likely to be painful. The general view has been that most of the methods used are virtually painless, and lead to rapid dignified death. Evidence is presented which shows that, with the possible exception of intravenous injection, this view is almost certainly wrong.

Topics: Capital Punishment; Cause of Death; Female; Humans; Injections, Intravenous; Male; Pain; Pain Measurement; Pancuronium; Poisoning; Thiopental; Wounds and Injuries

Management of pain in very low birth weight infants is limited by a lack of empiric knowledge about the multiple determinants of biobehavioral reactivity in infants receiving neonatal intensive care.. To examine relationship of early neonatal factors and previous medication exposure to subsequent biobehavioral reactivity to acute pain of blood collection.. Prospective cohort study. Methods. One hundred thirty-six very low birth weight (

Topics: Blood Specimen Collection; Cohort Studies; Dexamethasone; Electrocardiography; Facial Expression; Female; Fentanyl; Heart Rate; Humans; Indomethacin; Infant; Infant, Newborn; Infant, Very Low Birth Weight; Male; Monitoring, Physiologic; Morphine; Pain; Pain Measurement; Pain Threshold; Pancuronium; Prospective Studies

The incidence of myalgia after suxamethonium was determined in 200 fit military male dental patients of European, Chinese and Nepalese descent. Half received pancuronium 1 mg and the other half received saline pretreatment on a randomised double-blind basis. The percentage incidence of postsuxamethonium myalgia after saline or pancuronium was found to be: Europeans 26%, 13%; Chinese 13%, 7%; Nepalese 20%, 14%. Although pancuronium reduced the incidence of myalgia by about 50% overall, these values were not significantly different from each other. The recovery of spontaneous ventilation following suxamethonium was quicker in the Europeans than in the Asians (p < 0.05). Pancuronium pretreatment also delayed the recovery of spontaneous ventilation and recovery from neuromuscular block (p < 0.05) but this was independent of ethnicity. The Europeans recovered from anaesthesia more quickly than the Asians. It was concluded that ethnicity affected recovery from suxamethonium and from anaesthesia but was not of clinical relevance to the incidence of myalgia in male Asians and Europeans.

Topics: Adolescent; Adult; Anesthesia Recovery Period; Anesthesia, Dental; China; Double-Blind Method; Europe; Humans; Male; Middle Aged; Muscular Diseases; Nepal; Pain; Pancuronium; Postoperative Complications; Succinylcholine; Time Factors

Muscle pain associated with single-bolus administration of suxamethonium is reported to be one of the common complications of this technique. Since suxamethonium is the most commonly used relaxant in our department and priming with nondepolarizing muscle relaxants is also reported to be linked with complications, while the literature concerning this problem is very contradictory, we wondered if the so-called "self-taming" method represents an alternative to pretreatment with nondepolarizing muscle relaxants. One hundred thirty-two patients (69 male, 63 female) were randomly allocated to three groups. Anesthesia was induced with thiopentone 7 mg/kg body weight. Group 1 (n = 44) was pretreated with 2 mg pancuronium bromide 3 min prior to full relaxation with suxamethonium 1.5 mg/kg. Group 2 (n = 43) received no pretreatment. Group 3 (n = 45) received 4 mg suxamethonium i.v. after induction. One minute later the remaining dose of suxamethonium was applied ("self-taming"). Muscle fasciculation and postoperative myalgia were verified by means of a score. Neuromuscular transmission was recorded on a monitor after controlled train-of-four stimulus and time of onset of neuromuscular blockade was measured. With regard to muscle fasciculation, postoperative pain, and onset of neuromuscular blockade, "self-taming" with suxamethonium yielded results identical to pretreatment with pancuronium bromide. It may therefore be considered as an alternative to pretreatment with nondepolarizing muscle relaxants.

Topics: Adult; Anesthesia, General; Drug Administration Schedule; Fasciculation; Female; Humans; Male; Middle Aged; Muscle Contraction; Muscle Relaxation; Neuromuscular Junction; Pain; Pancuronium; Succinylcholine

Topics: Anesthesia; Barbiturates; Capital Punishment; Humans; Injections, Intravenous; Pain; Pancuronium; Physician's Role; Potassium Chloride; Prisoners; United States

Topics: Anesthesia; Barbiturates; Capital Punishment; Humans; Injections, Intravenous; Pain; Pancuronium; Physicians; Potassium Chloride; Prisoners; Refusal to Participate; Stress, Psychological; United States

Despite accumulating evidence that procedural pain experienced by preterm infants may have acute detrimental and even long-term effects on an infant's subsequent behavior and neurological outcome, neonates admitted to Neonatal Intensive Care Units still frequently experience acute and prolonged uncontrolled pain. Many invasive and surgical procedures are routinely performed at the bedside in the NICU without adequate pain management.. To develop evidence-based guidelines and recommendations for pain control and prevention in Italian i.e. heel lancing, venipuncture and percutaneous venous line positioning, tracheal intubation, mechanical ventilation, lumbar puncture, chest tube positioning, for certain surgical procedures performed at the NICU, e.g. central venous cutdown, surgical PDA ligation, and cryotherapy, laser therapy for ROP, and for postoperative pain management.. Adequate pain prevention and management should be an essential part of standard health care at the NICU, and recognizing and assessing sources of pain should be routine in the day-to-day practice of physicians and nurses taking care of the newborn. We hope these guidelines will contribute towards increasing the NICU caregiver's awareness and understanding of the importance of adequate pain control and prevention.

Topics: Adjuvants, Anesthesia; Analgesics; Analgesics, Opioid; Anesthetics, Local; Atropine; Drug Therapy, Combination; Humans; Hypnotics and Sedatives; Infant, Newborn; Intensive Care Units; Italy; Ketamine; Lidocaine; Midazolam; Neonatology; Neuromuscular Nondepolarizing Agents; Pain; Pancuronium; Perioperative Care; Postoperative Care; Treatment Outcome

Topics: Asphyxia; Capital Punishment; Consciousness; Drug-Related Side Effects and Adverse Reactions; Humans; Injections, Intravenous; Kentucky; Pain; Pancuronium; Pharmaceutical Preparations; Potassium Chloride; Prisoners; Thiopental

Topics: Capital Punishment; Consciousness; Drug-Related Side Effects and Adverse Reactions; Humans; Injections, Intravenous; Pain; Pancuronium; Paralysis; State Government; Tennessee; United States

Topics: Data Collection; Humans; Intensive Care Units; Midazolam; Morphine; Nursing Staff, Hospital; Pain; Pancuronium