NONDEPOLARIZING-NEUROMUSCULAR BLOCKING-DRUGS IN THE INTENSIVE-CARE UNIT - A CLINICAL REVIEW

Background, The use of nondepolarizing neuromuscular blocking drugs (N DNMBDs) via continuous infusion in the intensive care unit (ICU) is ga ining in popularity. Several new NDNMBDs have been developed recently; these drugs vary in their elimination, metabolism, and half-lives. Me thods. A review of the recent English language literature was done, wi th those articles relevant to the ICU being incorporated into this pap er. Results, The six most frequently used NDNMBDs, consisting of atrac urium, cisatracurium, doxacurium, pancuronium, rocuronium, and vecuron ium, were reviewed. The neuromuscular junction and impulse transmissio n, clinical monitoring, clinical pharmacology, the elimination and met abolism, the adverse reactions, and the drug interactions of these NDN MBDs are reviewed. Conclusions, The use of NDNMBDs is progressively in creasing in ICUs. Proper understanding of normal neuromuscular physiol ogy, clinical pharmacology, and drug interactions is essential to opti mize patient care and to minimize the risk of adverse reactions.