Clinical Experience of Long-term Use with Muscle Relaxants in the ICU

Muscle relaxants are used to support mechanical ventilation in the ICU. Large doses of muscle relaxant are given to ICU patients in particular who are sometimes much sicker than general surgical patients.Many problems are related to use muscle relaxants in the ICU. We presented and discussed problems which occured in our ICU patients who received large doses of two different kinds of muscle relaxants-vecuronium and pipecuronium for more than 24 hours. We found that it took much longer to recover from the blockade with vecuronium than pipecuronium.Based on these clinical experience, we would like to suggest that data obtained from surgical anesthesia may not apply to ICU patients with many pathophysiological risks. We do not recommend to use muscle relaxants more than 24 hour sand recommend to give sedatives instead of muscle relaxants for supporting mechanical ventilation. We also recommend to monitor neuromuscular function to prevent profound block.