Korean J Crit Care Med.  2006 Jun;21(1):28-36.

The Usage Pattern of Neuromuscular Blocker at Intensive Care Unit

• Song JG
• Jung HS
• Lee JD
• Lee YK
• Yang HS

Abstract

BACKGROUND: The neuromuscular blocker is helpful to intubate the patients and reduce the amount of anesthetic agent. It also used at intensive care unit (ICU) to maintain airway patency, to achieve proper ventilatory care, etc. This survey is to determine the neuromuscular blocker usage patterns in ICU settings.
METHODS
Three hundred general hospitals with ICU settings were chosen. We designed a 10 itemed questionnaire which has several subquestions with multiple choices and sent it to them. After three months, forty seven hospitals returned the questionnaire and we made careful analysis with it.
RESULTS
The most frequent indication of neuromuscular blocker was to facilitate the mechanical ventilation (80.9%). Vecuronium was the most common neuromuscular blocker used (97.9%). Only 6.4% of them used peripheral nerve stimulator and the rest of them (89.4%) used clinical information to determine the degree of neuromuscular blocker. The respondents reported that recovery from muscle relaxation was needed on a periodic basis for regular neurological examinations (59.6%) in ICU settings. All respondents used the sedatives or narcotics with neuromuscular blocker and only 6.4% used reversal agents.
CONCLUSIONS
Although the rate of reply was not much (15.7%), we could get the current usage pattern of neuromuscular blocker at ICU. We recommend using short to intermediate acting neuromuscular blocker than long acting agents. Continuous infusion with careful dosage titration by peripheral nerve stimulator would be helpful to achieve rapid recovery. Additional sedatives and narcotics are beneficial to reduce the amount of neuromuscular blocker and to make patients comfortable as well.

Keyword

Intensive care unit; Neuromuscular blocker

MeSH Terms

Surveys and Questionnaires
Hospitals, General
Humans
Hypnotics and Sedatives
Intensive Care Units*
Critical Care*
Muscle Relaxation
Narcotics
Neurologic Examination
Neuromuscular Blockade*
Peripheral Nerves
Surveys and Questionnaires
Respiration, Artificial
Vecuronium Bromide
Hypnotics and Sedatives
Narcotics
Vecuronium Bromide