Vecuronium question

[VickyRN]

Had a patient on vecuronium tonight. Paralyzed, no longer bucking the vent. However, he started developing a paralytic ileus (bowel sounds very hypoactive--large residuals--tube feedings had to be turned off.) Can vercuronium also paralyze the smooth involuntary GI track muscles????

P.S. What about the heart---if one were to get too big of a dose:eek: We try to keep the level of paralysis within a narrow confine by the train of four (peripheral nerve stimulator).

[Jenny P]

As an MDA told me as he gave me some for knee arthroscopy:

DIPROVAN= MILK OF AMNESIA!!!!!

Great stuff if you don't want them to remember..... :D :chuckle :chuckle

[nilepoc]

I can tell you that in my institution, vec. dripss are common practice, especially with pressure control ventilation, and CMV modes. We routinely give ativan and fentanyl or MSO4 along with the vec. No patient should ever be paralyzed without a sedative and and analgesic.

In my experience, the bowel ileus is from the opiates as hypothesized earlier.

[RN_PICU]

As nurse in a hospital setting I would always advise having neostigmine order on stand by before administering vec... just my 2 cents :)

[MomRN0913]

diprovan, vecuronium and mso4 all together??? why? somebody please help me out on this one?

me :)

paralytics don't sedate you. imagine being totally paralyzed but awake? how scary!

diprivan doesn't sedates you, but doesn't take your pain away.

and that's where morphine comes in.

[kids]

FYI, this thread is NINE years old

[MomRN0913]

Holy crap, yes it is. I missed a few pages of it too.

I must say, it is intereting to go back and read about this patient. I can't believe he was still alive.

[ECMO]

You're correct. If a patient is paralyzed, THEY MUST BE SEDATED. BELIEVE ME. I know how it feels being awake, intubated, AND paralyzed. It is, HORRIFYING. WITH ANY PARALYTIC, MUST COME SEDATION.

[ECMO]

PARALYTICS without sedatives, I don't think you will see that. BECAUSE WITH ANY PARALYTIC MUST come sedation, AND analgesia.

Vecuronium, is a paralytic.

Diprivan is a sedative/hypnotic.

Diprivan/propofol is able to be administered to do something as minor as keep your patients a little bit drowsy, to keep this completely knocked out.

BIS is VERY important in these4 ICU settings.

BIS is a Very useful monitor for monitoring sedation.

[Esme12, ASN, BSN, RN]

The BIS monitors are very helpful but not widely used in 2002 when this thread was started......Train of four was widely used and you prayed they were sedated.