Clinical Evaluation of Pipecuronium Bromide and its Comparison with Pancuronium Bromide

The study was carried out to compare the intubating conditions, cardiovascular responses, neuro-muscular blocking properties and reversal characteristics of pipecuronium bromide and pancuronium bromide. This is a prospective hospital based study. 100 patients belonging to ASA grade I or II physical status aged 18 to 70 years were divided into two groups of 50 patients each. Group 1 received pipecuronium bromide in the dose of .08 mg / kg and group 2 patients received pancuronium bromide in dose of 0.1 mg/kg. Each patient was pre medicated uniformly. Time for onset of apnoea for pipecuronium and pancuronium were 91.64+ 3.59 sec. and 118.84 + 12.53 sec. respectively. The mean time for intubation was 126.60 +12.55 sec. and 144.60 + 22.87 sec. with pipecuronium and pancuronium respectively. Mean duration of block for pipecuronium was 78.64 + 8.97 min. the block for pancuronium lasted from +36-40 min with a mean duration of block 41.60+ 5.57 min. The mean duration of maintenance dose in pipecuronium cases was 45.08 + 7.19 min., while it was 27.06 + 5.01 min in pancuronium cases. Pipecuronium patients did not show significant hemodynamic changes while hemodynamic changes were seen with pancuronium patients due to mild atropine like and sympathomimetic action of pancuronium. There was no spontaneous recovery in both groups of patients. All patients required titrated dosage of atropine / neostigmine. In pipecuronium patients, after reversal, 90% of patients had adequate recovery and scored a high score between 11-15. In pancuronium patients, after reversal, 88% had adequate recovery and scored a high score between11-15. It is evident that pipecuronium bromide provided excellent intubating conditions, negligible cardiovascular disturbances, longer duration of action, lack of cumulative action, easy reversibility of neuromuscular block with high postoperative recovery score. Thus it proves to be the ideal muscle relaxant of choice in the long surgical procedure.