Prolonged use of paralytics

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Specializes in ICU.

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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Specializes in Anesthesia.
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).

Annals of Intensive Care | Full text | A fresh look at paralytics in the critically ill: real promise and real concern

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http://www.atsjournals.org/doi/abs/10.1164/rccm.201107-1320OE#.UquFTY0fV_w

I have had that one saved for some time now. I don't think it addresses exactly what you're looking for (prolonged NM blockade) but it brings up a lot of very good points. Worth the read.

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Specializes in Critical Care.

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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Specializes in Surgery, Trauma, Medicine, Neuro ICU.

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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