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Use of Neuromuscular Blocking Agents in the Intensive Care Unit

  • Rodger E. Barnette
  • Ihab R. Kamel
  • Lilibeth Fermin
  • Gerard J. Criner
Chapter

Abstract

Understand the pharmacokinetics and pharmacodynamics of various neuromuscular blocking (NMB) agents. Understand the complications associated with the prolonged use of NMB agents in the critically ill patient and how to minimize them. Recognize the potential for interaction among commonly used drugs and NMB agents. Make recommendations regarding the use and dose of NMB agents in the critically ill. Understand the need for routine and effective sedation and analgesia in the critically ill patient receiving NMB agents in order to prevent awareness and pain. Understand the need for evaluation and monitoring of neuromuscular function in the critically ill patient receiving NMB agents.

Keywords

Ulnar Nerve Neuromuscular Blockade Nicotinic Acetylcholine Receptor Malignant Hyperthermia Neuromuscular Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Additional Reading

  1. Murray M, Cowen J, DeBlock H et al (2002) Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient. Crit Care Med 30:142–156PubMedCrossRefGoogle Scholar
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  7. Caldwell JE, Szenohradszky J, Segredo V et al (1994) The pharmacodynamics and pharmacokinetics of the metabolite 3-desacetylvecuronium (ORG 7268) and its parent compound, vecuronium, in human volunteers. JPET 270:1216–1222Google Scholar
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  12. Martyn JAJ, White DA, Gronert GA et al (1992) Up-and-down regulation of skeletal muscle acetylcholine receptors. Anesthesiology 76:822–843PubMedCrossRefGoogle Scholar
  13. Rich MM, Teener JW, Raps EC et al (1996) Muscle is electrically inexcitable in acute quadriplegic myopathy. Neurology 46: 731–736PubMedCrossRefGoogle Scholar
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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Rodger E. Barnette
    • 1
  • Ihab R. Kamel
    • 2
  • Lilibeth Fermin
    • 3
  • Gerard J. Criner
    • 4
  1. 1.Department of AnesthesiologyTemple University School of MedicinePhiladelphiaUSA
  2. 2.Department of AnesthesiologyTemple University HospitalPhiladelphiaUSA
  3. 3.Department of AnesthesiologyUniversity of Arizona College of Medicine, Southern Arizona VA Health SystemTusconUSA
  4. 4.Pulmonary and Critical Care Medicine and Temple Lung CenterTemple University School of MedicinePhiladelphiaUSA

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