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A Retrospective Analysis of Long‐Term Use of Nondepolarizing Neuromuscular Blocking Agents in the Intensive Care Unit, and Guidelines for Drug Selection
Author(s) -
Ciarens Diann M.,
Kelly Karl J.,
Gilliland Susan S.,
Kohls Philip K.,
Nahum Avi,
VanceBryan Kyle
Publication year - 1993
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1993.tb02773.x
Subject(s) - medicine , neuromuscular blocking agents , neuromuscular blockade , intensive care unit , intensive care , intensive care medicine , drug , retrospective cohort study , weakness , dose , anesthesia , emergency medicine , pharmacology , surgery
Nondepolarizing neuromuscular blocking agents (NNMBAs) are frequently administered to patients in the intensive care unit (ICU). We conducted a retrospective study of patients in intensive care who received infusions (>48 hrs) of commonly used NNMBAs. The goals were to describe NNMBA use in our ICUs, determine patient characteristics, and assess the cost of the individual drugs. We found that atracurium was prescribed for 68% of study patients; 68% of the patients did not have renal, hepatic, or cardiovascular disease; dosages of NNMBAs varied; a statistically significant increase in dosage requirements over time occurred with atracurium; assessment of neuromuscular blockade was 100% subjective; and 41% and 17% of patients receiving atracurium and vecuronium, respectively, experienced prolonged neuromuscular weakness documented subjectively. As a result of this study, guidelines for agent selection were developed to facilitate cost effective use of NNMBA in our ICUs. Using these guidelines would potentially significantly decrease drug expenditures in this setting.