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Korean J Crit Care Med > Volume 21(1); 2006 > Article
Korean Journal of Critical Care Medicine 2006;21(1): 28-36.
중환자실에서 근이완제의 사용 실태
울산대학교 의과대학 서울아산병원, *강릉아산병원 마취통증의학과
The Usage Pattern of Neuromuscular Blocker at Intensive Care Unit
Jun Gol Song, Hwa Sung Jung, Jae Do Lee, Yoon Kyung Lee, Hong Seuk Yang
1Department of Anesthesiology and Pain Medicine, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. jaljary@naver.com
2Department of Anesthesiology and Pain Medicine, Kangneung Asan Medical Center, Gangneung, Korea.
BACKGROUND: The neuromuscular blocker is helpful to intubate the patients and reduce the amount of anesthetic agent. It also used at intensive care unit (ICU) to maintain airway patency, to achieve proper ventilatory care, etc. This survey is to determine the neuromuscular blocker usage patterns in ICU settings. METHODS: Three hundred general hospitals with ICU settings were chosen. We designed a 10 itemed questionnaire which has several subquestions with multiple choices and sent it to them. After three months, forty seven hospitals returned the questionnaire and we made careful analysis with it. RESULTS: The most frequent indication of neuromuscular blocker was to facilitate the mechanical ventilation (80.9%). Vecuronium was the most common neuromuscular blocker used (97.9%). Only 6.4% of them used peripheral nerve stimulator and the rest of them (89.4%) used clinical information to determine the degree of neuromuscular blocker. The respondents reported that recovery from muscle relaxation was needed on a periodic basis for regular neurological examinations (59.6%) in ICU settings. All respondents used the sedatives or narcotics with neuromuscular blocker and only 6.4% used reversal agents. CONCLUSIONS: Although the rate of reply was not much (15.7%), we could get the current usage pattern of neuromuscular blocker at ICU. We recommend using short to intermediate acting neuromuscular blocker than long acting agents. Continuous infusion with careful dosage titration by peripheral nerve stimulator would be helpful to achieve rapid recovery. Additional sedatives and narcotics are beneficial to reduce the amount of neuromuscular blocker and to make patients comfortable as well.
Key Words: Intensive care unit; Neuromuscular blocker
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