Comprehensive review: neuromuscular blocking agents in critical care

Management of pharmacologically induced neuromuscular blockade using peripheral nerve stimulation

Currently, many critically ill patients are treated with neuromuscular blocking agents to facilitate endotracheal intubation, mechanical ventilation, and manage confused, combative, head injured, and status epileptus patients. To prevent persistent pharmacologically induced paralysis, the aide of a peripheral nerve stimulator and clinical indicators may help determine the minimal effective drug dose to facilitate safe neuromuscular blockade. The purpose of this article is to provide nursing clinicians the essential knowledge to manage patients with neuromuscular blockade effectively using peripheral nerve stimulation monitoring.

Adverse responses to analgesia, sedation, and neuromuscular blocking agents in infants and children

Analgesics, sedation, and neuromuscular blocking agents are commonly used in treating critically ill infants and children. Although these medications are beneficial and imperative to the care of the child, their use is not risk free. Adverse responses occur in these children. With improved methods for use and monitoring, adverse responses can be minimized.