• Pipecuronium comes as a powder for injection as 10mg single dose vial and should be administered intravenously under the supervision of an expert.
• It is recommended for surgeries that last longer than one and a half an hour because of the long-acting effect of pipecuronium.
• Adult Dose:
The usual adult dose range is 50 - 100 mcg/kg.
• Endotracheal intubation under balanced anesthesia:
For patients with normal kidney function and not obese, the recommended initial dose is 70 - 85mcg/kg which offers approximately 1 to 2 hours of clinical relaxation.
• Recovery from succinylcholine used for endotracheal intubation:
A dose of 50mcg/kg is injected which provides relaxation of approximately 45 minutes. It should not be used before succinylcholine.
• Maintenance dose:
A dose of 10 - 15mcg/kg under balanced anesthesia provides approximately 50 minutes of relaxation.
• Child Dose under balanced and inhalational anesthesia:
Infants 3 months to 1 year: 40mcg/kg dose of relaxation of 10 to 44 minutes
Children 1 year to 14 years of age: 57mcg/kg dose for a relaxation of 18 to 52 minutes
Pipecuronium should not be used in neonates and infants below 3 months of age.
• Pipecuronium should not be used either before or after other non-depolarizing neuromuscular blocking agents or in patients requiring long-term mechanical ventilation in the intensive care unit (ICU).
• It is also not advised to use it in cases of cesarean sections due to the risk of transfer of the drug through the placenta to the fetus. Also, the effect of the drug lasts for longer than the duration of the cesarean section.
• It is recommended for surgeries that last longer than one and a half an hour because of the long-acting effect of pipecuronium.
Dosage & When it is to be taken
The dose is calculated according to the age, sex, body weight or degree of obesity, kidney function, liver disease and other existing diseases in the patient.• Adult Dose:
The usual adult dose range is 50 - 100 mcg/kg.
• Endotracheal intubation under balanced anesthesia:
For patients with normal kidney function and not obese, the recommended initial dose is 70 - 85mcg/kg which offers approximately 1 to 2 hours of clinical relaxation.
• Recovery from succinylcholine used for endotracheal intubation:
A dose of 50mcg/kg is injected which provides relaxation of approximately 45 minutes. It should not be used before succinylcholine.
• Maintenance dose:
A dose of 10 - 15mcg/kg under balanced anesthesia provides approximately 50 minutes of relaxation.
• Child Dose under balanced and inhalational anesthesia:
Infants 3 months to 1 year: 40mcg/kg dose of relaxation of 10 to 44 minutes
Children 1 year to 14 years of age: 57mcg/kg dose for a relaxation of 18 to 52 minutes
Pipecuronium should not be used in neonates and infants below 3 months of age.
When it is not to be taken (Contraindications)
• Due to the long duration of action of pipecuronium, it is not advised to use it in myasthenia gravis or Eaton-Lambert syndrome, a long-term neuromuscular disorder that causes skeletal muscle weakness.• Pipecuronium should not be used either before or after other non-depolarizing neuromuscular blocking agents or in patients requiring long-term mechanical ventilation in the intensive care unit (ICU).
• It is also not advised to use it in cases of cesarean sections due to the risk of transfer of the drug through the placenta to the fetus. Also, the effect of the drug lasts for longer than the duration of the cesarean section.
