Abstract：
Pancuronium(bromide) is used because of its relaxing effect on striated muscles and usually requires artificial respiration. A 52-year-old woman suffered from long-standing \"generalized dystonia\", which had become resistant to conventional therapy. Therefore, an anesthetist established a permanent medication scheme with pancuronium using a PCA pump. This pump had been controlled by the patient herself ensuring an acceptable quality of life with broad personal autonomy. Finally, the woman was found dead in her flat by a member of a home nursing service. The infusion hose showed a fixed knot and further blocking by a clamp. The autopsy findings were non-specific, except for the presence of opioid tablets in the colon. Toxicological analyses showed 72ng/ml pancuronium and 21 ng/ml oxycodone (therapeutic) in the femoral venous blood. The range of published pancuronium levels varies from approx. 80 to 2,000 ng/ml. Thus it had to be assumed that the pancuronium level was too low (72 ng/ml) so that symptoms of dystonia recurred. Based on extensive literature research, the described case can be qualified as unique. The therapy concept had been innovative, sufficient and effective for more than 10 years. It allowed the patient to enjoy a maximum of autonomy. Ultimately, death was due to the blocked pancuronium infusion. The relatively low pancuronium level had provoked the dystonia to return with generalized spasms also involving the respiratory muscles resulting in respiratory arrest. During the police investigations, two previous suicide attempts came to light.
摘要：
使用潘库溴铵（溴化物）是因为它对横纹肌有放松作用，通常需要人工呼吸。一名52岁的妇女长期患有“广泛性肌张力障碍”，已经对常规治疗产生了抗药性。因此,麻醉师使用PCA泵建立了潘库溴铵的永久性药物治疗方案。该泵由患者自己控制，以确保具有广泛的个人自主权的可接受的生活质量。最后,一名家庭护理服务人员发现该名女子死在她的公寓里。输液软管显示出固定的结，并被夹子进一步阻塞。尸检结果是非特异性的,除了在结肠中的阿片类药物片剂的存在。毒理学分析显示，股静脉血中的潘库溴铵和羟考酮（治疗性）为72ng/ml。已发布的泛库溴铵水平范围约为。80至2,000ng/ml。因此，必须假设潘库溴铵水平太低（72ng/ml），以致肌张力障碍的症状复发。基于广泛的文献研究，所描述的案例可以被限定为唯一的。治疗概念是创新的，足够和有效的超过10年。它允许患者享有最大的自主权。最终,死亡是由于潘库溴铵输注受阻。相对较低的潘库溴铵水平引起肌张力障碍，伴有全身痉挛，也涉及呼吸肌，导致呼吸停止。在警方调查期间,前两次自杀企图曝光。
