ICU: Neuromuscular Blocking Agents
What are neuromuscular blocking agents?
Neuromuscular blocking agents are drugs used in the intensive care unit which act on nerves and muscles to cause a controlled muscle weakness and relaxation. Examples of neuromuscular blockers include atracurium, cisatracurium, rocuronium and vecuronium.
Why are neuromuscular blocking agents used?
Patients who require a mechanical ventilator (breathing machine) sometimes have a difficult time allowing the ventilator to breathe for them. This is sometimes referred to as “overbreathing” or “fighting” the ventilator. In order for the patient to receive enough oxygen, this must be controlled. Neuromuscular blocking agents relax the patient’s muscles and this allows the ventilator to do the breathing for the patient.
How will the patient look or feel on neuromuscular blocking agents?
This controlled muscle weakness will limit the patient’s use of most of the muscles in their body, so they will not be able to move their arms or legs. They will look very still although they may still be able to hear. To eliminate any discomfort, patients will also need to be made sleepy during the time they are relaxed by using a sedation agent. The sedation will also make the patient unable to remember much of the time spent in the intensive care unit.
What are the side effects of neuromuscular blocking agents?
Neuromuscular blockers have few side effects. They can affect heart rate and blood pressure, but these are constantly monitored. Patients may also be weak for a period of time after the medicine is shut off. This should slowly improve with time.
How is the level of relaxation being monitored?
Too much or too little relaxation can hamper treatment. The TLC staff will assess the level of relaxation several times a day to ensure that the neuromuscular blocking agents are working properly and safely. This will be done by “twitching” one of the patient’s nerves with a stimulator. This does not hurt. The length of time the patient remains on the neuromuscular blocking agent depends on breathing status, but the drug will be stopped by the health care team as soon as possible.
If you have questions about neuromuscular blocking agents or other questions relating to the patient’s care, please ask the staff in the intensive care unit.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 05/14/2013
Copyright © 05/14/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5200
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