Prolonged Weakness after Long-Term Infusion of Vecuronium Bromide
Authors: Yizhak Kupfer, Tatsuji Namba, Emad Kaldawi, Sidney Tessler
Journal: Annals of Internal Medicine (1992)

Brief Reports15 September 1992Prolonged Weakness after Long-Term Infusion of Vecuronium BromideYizhak Kupfer, MD, Tatsuji Namba, MD, PhD, Emad Kaldawi, MD, Sidney Tessler, MDYizhak Kupfer, MD, Tatsuji Namba, MD, PhD, Emad Kaldawi, MD, Sidney Tessler, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-6-484 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptVecuronium bromide is a nondepolarizing neuromuscular blocking agent chemically similar to pancuronium, but with minimal cardiovascular side effects (1). Unlike other neuromuscular blocking agents, vecuronium does not cause significant histamine release, which can lead to bronchoconstriction in patients with asthma. Because of its short duration of action, vecuronium can be administered by continuous intravenous infusion. In patients without renal impairment, large doses do not result in accumulation. Thus, vecuronium appears to be an ideal agent to achieve muscle relaxation for patients with respiratory failure, especially status asthmaticus.In recent years, reports have linked prolonged use of neuromuscular blocking agents to...References1. MorrisCahalanMillerWilkinsonQuashaRobinson RMRPAS. The cardiovascular effects of vecuronium (ORG NC 45) and pancuronium in patients undergoing coronary artery bypass grafting. Anesthesiology. 1983;58:438-40. CrossrefMedlineGoogle Scholar2. SegredoMatthaySharmaGruenkeCaldwellMiller VMMLJR. Prolonged neuromuscular blockade after long term administration of vecuronium in two critically ill patients. Anesthesiology. 1990;72:566-70. CrossrefMedlineGoogle Scholar3. PartridgeAbramsBazemoreRubin BJCR. Prolonged neuromuscular blockade after long term infusion of vecuronium bromide in the intensive care unit. Crit Care Med. 1990;18:1177-9. CrossrefMedlineGoogle Scholar4. ShanksLongAitkenhead ATA. Prolonged neuromuscular blockade following vecuronium. A case report. Br J Anaesth. 1985; 57:807-10. CrossrefMedlineGoogle Scholar5. SlaterPollardDoran RBB. Prolonged neuromuscular blockade with vecuronium in renal failure. Anaesthesia. 1988;43:250. CrossrefMedlineGoogle Scholar6. GoochSuchytaBalbierzPetajanClemmer JMJJT. Prolonged paralysis after treatment with neuromuscular junction blocking agents. Crit Care Med. 1991;19:1125-31. CrossrefMedlineGoogle Scholar7. KupferOkrentTwerskyTessler YDRS. Disuse atrophy in a ventilated patient with status asthmaticus receiving neuromuscular blockade. Crit Care Med. 1987;15:795-6. CrossrefMedlineGoogle Scholar8. StarsnicGoldbergRitterMarratSosisLarijani MMDMG. Does vecuronium accumulate in the renal transplant patient? Can J Anaesth. 1989;36:35-9. CrossrefMedlineGoogle Scholar9. Van MarieWoods WK. Acute hydrocortisone myopathy. BMJ. 1980;281:271-2. CrossrefGoogle Scholar10. ZochodneBoltonWellsGilbertHahnBrown DCGJAJ. Critical illness polyneuropathy. A complication of sepsis and multiple organ failure. Brain. 1987;110:819-42. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From Maimonides Medical Center, Brooklyn, New York. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPharmacokinetics and Pharmacology of Drugs Used in ChildrenSedation and analgesia in patients who need mechanical ventilation in intensive care unitCorticosteroids and neuromuscular blockers in development of critical illness neuromuscular abnormalities: A historical reviewICU-Acquired WeaknessIntractable Polyuria Mimicking Diabetes Insipidus—Source Traced to Vecuronium InfusionDiseases of the Peripheral Nervous SystemAcute Neuromuscular Weakness in the Intensive Care UnitLa neuromyopathie acquise en réanimationElectrophysiology of neuromuscular disorders in critical illnessNeuromuscular complications of critical illnessA fresh look at paralytics in the critically ill: real promise and real concernICU-acquired weaknessAcute Exacerbations of Chronic Obstructive Pulmonary Disease in the Emergency DepartmentNeuromuscular Blockade and Skeletal Muscle Weakness in Critically Ill PatientsNeuromuscular Disorders in Critically Ill Patients: Review and UpdateManagement of Critical Illness Polyneuropathy and MyopathyUse of Neuromuscular Blocking Agents in the Intensive Care UnitPharmacology of Muscle Relaxants and Their AntagonistsMyofibrillar protein and gene expression in acute quadriplegic myopathyPharmacokinetics and Pharmacology of Drugs Used in ChildrenMechanical VentilationNeuromuscular dysfunction acquired in critical illness: a systematic reviewA Markov computer simulation model of the economics of neuromuscular blockade in patients with acute respiratory distress syndromeBrief review: Nondepolarizing neuromuscular blocking drugs and critical illness myopathyNeuromuscular manifestations of critical illnessCritical Illness NeuromyopathyElectrophysiologic Evaluation of Patients in the Intensive Care UnitCrush injury and rhabdomyolysisAcquired Neuromuscular Disorders in the Intensive Care UnitAn Algorithm for Train-of-Four Monitoring in Patients Receiving Continuous Neuromuscular Blocking AgentsClinical assessment of long-term infusion of vecuronium in pediatric intensive careWhat a Clinician Should Do When a Patient "Fights the Ventilator"Chapter 29 Critical care myopathiesCritical illness neuromuscular abnormalitiesNeuromuscular monitoring and clinical applications: What to do, when, and why?Management of the acute respiratory distress syndromeVecuronium-associated axonal motor neuropathy: a variant of critical illness polyneuropathy?Recommendations on the Appropriate Use of the Muscle RelaxantAcute weakness syndromes in the critically ill patientPolyneuropathies et neuromyopathies de réanimationNeurologic complications of critical illness and transplantationUtilisation des curares en réanimationRisk Factors for Polyneuromyopathy of Critical IllnessClinical and electrophysiological findings in critical illness polyneuropathyRhabdomyolysis and Myoglobinuric Renal Failure in Trauma and Surgical Patients: A ReviewCauses of neuromuscular weakness in the intensive care unit: A study of ninety-two patientsCritical illness myopathy unrelated to corticosteroids or neuromuscular blocking agentsSIRS and Sepsis-Induced Neuromuscular DysfunctionsAcute Weakness Syndromes in Critically Ill Patients—A ReappraisalA prospective, randomized, controlled evaluation of peripheral nerve stimulation versus standard clinical dosing of neuromuscular blocking agents in critically ill patientsNeuromuscular Complications of Prolonged Critical CareA Method to Produce Sedation in Critically Ill PatientsEconomic impact of prolonged motor weakness complicating neuromuscular blockade in the intensive care unitSepsis and the systemic inflammatory response syndromeGeneralized Paralysis in the Intensive Care Unit: Emphasis on the Complications of Neuromuscular Blocking Agents and CorticosteroidsCritical illness myopathy and neuropathyNeuromuscular complications in the ICU: the spectrum of critical illness-related conditions causing muscular weakness and weaning failureQuadriplégie par myopathie aiguë acquise en réanimation compliquant un asthme aigu graveMuscle relaxants in the intensive care unitParalysis has no effect on chest wall and respiratory system mechanics of mechanically ventilated, sedated patientsComplications Associated with Sedative and Neuromuscular Blocking Drugs in Critically Ill PatientsAAEM case report #29: Prolonged paralysis after neuromuscular blockadeTopical Review: Neuromuscular Complications of Sepsis in ChildrenAtracurium and status epilepticus?Optimizing Sedation in Critically Ill, Mechanically Ventilated PatientsAcute quadriparesis in an asthmatic treated with atracuriumMuscle Relaxants in the Intensive Care UnitProlonged Paralysis After Neuromuscular BlockadeThe Clinical Spectrum of Critical Illness PolyneuropathyProlonged Muscle Weakness After Neuromuscular Blockade in the Intensive Care UnitNeuromuscular Blocking Agents in the Management of Respiratory Failure: Indications and Treatment GuidelinesLIFE-THREATENING ASTHMAElectrodiagnostic Studies of the Neuromuscular Respiratory SystemProlonged paralysis after long-term infusion of neuromuscular blocking agentsMuscle relaxants and neuromuscular disorders in the intensive care unitThe Polyneuropathy of Critical IllnessCritically ill patient with newly acquired weakness: The clinicopathological spectrumRapidly evolving myopathy with myosin-deficient muscle fibersAIRWAY MANAGEMENT IN RESPIRATORY EMERGENCIESRESPIRATORY DISTRESS IN THE VENTILATED PATIENTNeuromuscular Blocking AgentsNeuromuscular blocking agents and skeletal muscle relaxantsUSE OF NEUROMUSCULAR BLOCKING AGENTS IN THE INTENSIVE CARE UNITNeuromuscular Blocking Agents in Critical CareMyopathy in Status Asthmaticus: Relation to Neuromuscular Blockade and Corticosteroid AdministrationNeuromuscular complications of sepsisNeuromuscular blocking agents and skeletal muscle relaxantsNeuromuscular Blockade in the Intensive Care Unit: More than We Bargained forPersistent Paralysis after Vecuronium AdministrationVecuronium bromide 15 September 1992Volume 117, Issue 6Page: 484-486KeywordsAsthmaCritical careHistamineMusclesMuscular dystrophiesNeuromuscular diseasesRespiratory failure Issue Published: 15 September 1992 PDF DownloadLoading ...