Neuromuscular Blocking Agents in Critically Ill Children

Neuromuscular blockade is used in critically ill children for a variety of reasons. The physiology and pharmacology of neuromuscular blocking agents is reviewed. The effect of hypothermia on the pharmacodynamics of neuromuscular blockade is discussed. The ideal agent would have a rapid rate of onset with spontaneous reversal after discontinuation. Patients receiving neuromuscular blocking agents need to be assessed for the degree of blockade that is being sustained. The need to temporarily discontinue infusions of neuromuscular blocking agents to enable an assessment of the level of sedation or to allow an assessment of neuromuscular function is highlighted. Paed Perinatal Drug Ther 2002; 5: 35–46