Pancuronium:

Intravenous nondepolarizing neuromuscular blocking agent

ECMO Dose Adjustment:

NONE

Renal Impairment Dose Adjustment*:

YES—a decreased dose may be warranted in some patients.

CRRT Dose Adjustment:

YES—a decreased dose may be warranted in some patients.

Hepatic Impairment Dose Adjustment*:

YES—a decreased dose may be warranted in some patients.

Adult Starting Dose^:

Adult Emergency Dose: 0.1 mg/kg IV x 1

Adult Intermittent: 0.05–0.1 mg/kg IV every 1–2 hrs

Adult Continuous: 0.8–1.2 mcg/kg/min

Pediatric starting dose^:

Pediatric Emergency Dose: 0.1 mg/kg IV x 1

Pediatric Intermittent: 0.05–0.1 mg/kg IV every 1–2 hrs

Pediatric Continuous Infusion: 0.8–1 mcg/kg/min

Neonatal starting dose^:

Neonatal Emergency Dose: 0.1 mg/kg IV x 1

Neonatal Intermittent: 0.05–0.1 mg/kg IV every 1–2 hrs

Neonatal Continuous Infusion: 0.8–1 mcg/kg/min

*Dose adjustment will be dependent on acuity and severity of impairment.

^Always use the lowest effect dose to achieve an objective endpoint (e.g., train-of-four, ventilator synchrony) and ensure adequate pain control and deep sedation prior to and during administration of neuromuscular blocking agents.