ROBIN L. KAPLAN, M.D.
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To the editor: I must take issue with a statement of Drs. Roizen and Feeley in their review of pancuronium bromide (1). In an otherwise excellent article, an assertion is made in the section on clinical use that is misleading. "Muscle relaxation protects the patient with a fluctuating state of consciousness (as in glutethimide overdose) from experiencing spontaneous extubation when awake, and then relapsing into coma and respiratory failure. Pancuronium bromide has been used to prevent laryngeal damage from the sudden, violent spontaneous extubation that can accompany awakening from sedative-hypnotic overdose." Extubation is not a "spontaneous" process, as implied in
KAPLAN RL. Extubation and Pancuronium. Ann Intern Med. 1978;88:846. doi: 10.7326/0003-4819-88-6-846_2
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Published: Ann Intern Med. 1978;88(6):846.
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