Question

Benefits/ risks with neuromuscular blockage meds

Answer 1

The Neuromuscular blocking agents play an important role in the management of large number of patients.In addition to their routine use in surgical anaesthesia,neuromuscular blocking agents may be valuable in many new and evolving critical care situations.

Benefits of Neuromuscular blocking agents includes,

1) NMBAs have been staple of anaesthesiology and surgery.The choice of agent and dosing varies widely depending on the surgical procedure and so on the use of alternative agents, including general anaesthetics and IV sedation medication.

2) Critical care.

a)Acute respiratory distress syndrome_one of the primary clinical concerns for patients who develop ARDS is to reduce pressure and stress on the lungs,thereby reducing additional inflammation beyond the initial damage.Because of their effects on diaphragmatic tone,NMBAs have been suggested as a method for decreasing ventilator asynchrony and pulmonary pressures.

b) Therapeutic hypothermis_,NMBAs have been proposed as part of many treatment algorithm for patients undergoing therapeutic hypothermia post cardiac arrest.

c) elevated intracranial pressure--ICP is routinely managed by deep sedation and analgesia,reducing oxygen consumption and cerebral metabolism while controlling pain,motion and ventilator asynchrony.The addition of NMBAs is considered only when deep sedation is insufficient for controlling dangerous increase in ICP,often a result of coughing, suctioning or shivering.

Risk factors

Hypersensitivity reactions, coughing,parosmia, and elevated urine levels