Skip to main content

Use, Abuse and Misuse of Drugs in the ICU: Muscle Relaxants

  • Conference paper

Abstract

Twenty years ago, muscle relaxants were frequently used in the ICU in almost all critically ill patients (91%), but ten years later a large survey reported frequent use of nondepolarizing muscle relaxants in only 16%, and recently, only 1% of adults and 5% of neonatal and other paediatric patients were therapeutically paralysed, because of new sedative techniques [1].

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Durbin CG (1991) Neuromuscular blocking agents and sedative drugs. Crit Care Clin 7 (3): 489–506

    PubMed  Google Scholar 

  2. Elliot JM, Bion JF (1995) The use of neuromuscular blocking drugs in the intensive care practice. Acta Anaesth Scand 39 [Suppl 106]: 70–82

    Article  Google Scholar 

  3. Sharpe MD (1992) The use of muscle relaxants in Intensive Care Unit. Can J Anaesth 39 (9): 949–962

    Article  PubMed  CAS  Google Scholar 

  4. Conti G, Vilardi V, Rocco M et al (1995) Paralysis has no effect on chest wall and respiratory system mechanics of mechanically ventilated, sedated patients. Intens Care Med 21: 808–812

    Article  CAS  Google Scholar 

  5. Werba A, Gilly H, Weindlmayr-Goettel M et al (1992) Porcine model for studying the passage of non-depolarizing neuromuscular blockers through the blood brain barrier. Br J Anaesth 69: 382–386

    Article  PubMed  CAS  Google Scholar 

  6. Berger J, Waldrom RE (1995) Analgesia, sedation and paralysis in the intensive care unit. Am Fam Physician 51 (1): 166–172

    PubMed  CAS  Google Scholar 

  7. Casale LM, Siegel R (1993) Neuromuscular blockade in the ICU. Chest 104 (5): 1639–1640

    PubMed  CAS  Google Scholar 

  8. Sharpe MD (1992) The use of muscle relaxants in the Intensive Care Unit. Can J Anaesth 39 (9): 949–962

    Article  PubMed  CAS  Google Scholar 

  9. Isenstein DA, Venner DS, Duggan J (1992) Neuromuscular blockade in the Intensive Care Unit. Chest 102: 1258–1266

    Article  PubMed  CAS  Google Scholar 

  10. Shapiro BA, Warren J, Egol AB et al (1995) Practice parameters for sustained neuromuscular blockade in the adult critically ill patient: an executive summary. Crit Care Med 23(9): 16011605

    Google Scholar 

  11. Gamrin L, Essen P, Forsberg AM et al (1996) A descriptive study of skeletal muscle metabolism in critically ill patients: free amino acids, energy-rich phosphates, protein, nucleic acids, fat, water and electrolytes. Crit Care Med 24 (4): 575

    Article  PubMed  CAS  Google Scholar 

  12. Bolton CF (1993) Neuromuscular complications of sepsis. Intens Care Med 19: S58 - S63

    Article  Google Scholar 

  13. Mercatello A, Coronel B, Mosckovtchenko JF (1995) La neuropathie de réanimation: un defi pour le futur. Ann Fr Anesth Réanim 14: 209–212

    Article  Google Scholar 

  14. Tobias J, Lynch A, McDuffee A et al (1995) Pancuronium infusion for neuromuscular block in children in the pediatric Intensive Care Unit. Anaesth Analg 81: 13–16

    CAS  Google Scholar 

  15. Silverman DG, Mirakhur RK (1994) Non-depolarizing relaxants of the 1990s. In: Silverman DG (ed) Neuromuscular block in perioperative and intensive care. JB Lippincott Company, Philadelphia, pp 200–216

    Google Scholar 

  16. Watling SM, Dasta JF (1994) Prolonged paralysis in Intensive Care Unit patients after the use of neuromuscular blocking agents: a review of the literature. Crit Care Med 22 (5): 884–893

    Article  PubMed  CAS  Google Scholar 

  17. Lamaire F (1993) Difficult weaning. Intens Care Med 19: S69 - S73

    Article  Google Scholar 

  18. Bolton CF (1994) Muscle weakness and difficulty in weaning from the ventilator in the critical care unit. Chest 106 (1): 1–2

    Article  PubMed  CAS  Google Scholar 

  19. Al-Muhandis WM, Lauretti GR, Pleuvry BJ (1991) Modification by drugs use in anaesthesia of CNS stimulation induced in mice by laudanosine and strychnine. Br J Anaesth 67: 608–613

    Article  PubMed  CAS  Google Scholar 

  20. Eddleston JM, Harper NJN, Pollard BJ et al (1989) Concentrations of atracurium and laudano-sine in cerebrospinal fluid and plasma during intracranial surgery. Br J Anaesth 63: 525–530

    Article  PubMed  CAS  Google Scholar 

  21. Gwinnutt CL, Edleston JM, Edwards D et al (1990) Concentration of atracurium and laudanosine in cerebrospinal fluid plasma in three intensive care patients. Br J Anaesth 65: 829–832

    Article  PubMed  CAS  Google Scholar 

  22. Maestrone E, Magnelli V, Nobile (1994) Extracellular pancuronium affects sodium current in chick embryo sensory neurones. Br J Pharmachol 11: 283–287

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer-Verlag Italia

About this paper

Cite this paper

Conti, G., Marella, R., Marini, M.C. (2000). Use, Abuse and Misuse of Drugs in the ICU: Muscle Relaxants. In: Gullo, A. (eds) Anesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2286-7_55

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2286-7_55

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0095-7

  • Online ISBN: 978-88-470-2286-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics