Comparison of the effects of pancuronium and atracurium on the lower esophageal sphincter.

The effects of pancuronium and atracurium on the lower esophageal sphincter pressure (LESP) were studied in 24 healthy patients anesthetized with 0.5% halothane in 66% nitrous oxide in oxygen. After pancuronium (0.1 mg X kg-1) given intravenously there was a significant increase in LESP from a control value of 36 +/- 4.0 cm H2O to 50 +/- 4.6 cm H2O at 1 min. This produced an increase in barrier pressure (BRP) from 26 +/- 3.7 cm H2O to 41 +/- 4.3 cm H2O. These changes were sustained for 5 min accompanied by a significant increase in arterial pressure and heart rate. Atracurium (0.6 mg X kg-1) had no cardiovascular effects and produced little changes in either LESP or BRP. The findings of this study suggest that pancuronium may be of benefit in a rapid sequence induction.