Indications of Muscle Relaxants and Methods of Paralysis Control in the Intensive Care Unit
Neuromuscular blocking agents (NBA) are sometimes used in the Intensive Care Unit (ICU) to facilitate endotracheal intubation and artificial ventilation, to decrease the tone of the striated muscles or to strictly immobilize the patient during technical investigations or therapeutical manoeuvres. These drugs are also of interest in reducing the oxygen consumption in some very critical conditions. To limit some undesirable effects of the NBA, their amount given must be accurately adjusted, according to the real hour by hour and day by day patient’s needs. Moreover, partial or complete paralysis must always be associated with adequate sedation to avoid psychological problems. Prolonged administration of NBA beyond a couple of days remains highly questionable in view of the danger of temporary and sometimes irreversible lesions produced by concomitant use of NBA and other molecules, such as some antibiotics interferring with the neuromuscular junction.
KeywordsHistamine Verapamil Diphenylhydantoin Nitroglycerine Aminoglycosides
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