LONG-TERM ADMINISTRATION OF PANCURONIUM AND PIPECURONIUM IN THE INTENSIVE-CARE UNIT

This study was performed to determine the optimum dose of pancuronium (n = 30) and pipecuronium (n = 30) under continuous sedation and analg esia in the intensive care unit (ICU). This was an open clinical inves tigation in 60 critically ill patients with head injury, multiple trau ma (in some complicated with sepsis and multi-organ failure), requirin g neuromuscular block for ventilation for at least 48 h. Emphasis was placed on the neuromuscular monitoring with a peripheral nerve stimula tor and adequate sedation and analgesia. Satisfactory block was achiev ed in all cases with an average dose of 3 mg/h with either compound. N one of the patients experienced prolonged paralysis, muscle weakness, or other neuromuscular dysfunctions in the postventilatory period. We suggest that adequate use of sedative hypnotics and opioids plus neuro muscular monitoring allowed us to optimize the dose of muscle relaxant s according to the need of individual patients.