Prolonged neuromuscular blockade for relaxation in two pediatric intensive care patients

Newer neuromuscular blocking drugs provide optimum blockade and can facilitate ventilation, yet if they are discontinued, they allow predictable reversal. This article documents the use of these drugs in the treatment of two pediatric intensive care unit patients who had different physiologic problems and pharmacologic needs and who were ventilator dependent for a prolonged period. In each case, neuromuscular blockade significantly facilitated ventilation and allowed time for treatment of the underlyingpathology without deleterious pharmacologic side effects resulting in a favorable outcome for both patients. The article discusses some of the unique pharmacologic properties o f these drugs and the rationale for their use.