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Discussion

Prolonged use of paralytics

Does anyone have any good resources/references/anecdotal instances on the effects of prolonged use of paralytics such as rocuronium and vecuronium? (10+ days at this point).

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    It's always been my impression that neuromuscular blockade is of little benefit beyond the first 48 to 72 hours. Greater than 10 days is unlikely to have much additional benefit, and the risks are greatly increased (permanent nervous system damage).

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    4 weeks once. Very unstable airway in a patient who needed a specially built trach with an extensive history of pulling out his ETT/trachs. Seriously. 4 weeks. He got his special airway, woke up and got sent out of the unit. I'm assuming there was quite a bit of muscle weakness. But 4 weeks.

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