title: Persistent paralysis after prolonged use of atracurium in the absence of corticosteroids.
abstract: Neuromuscular blocking agents (NMBAs) are often used for patients requiring prolonged mechanical ventilation. Reports of persistent paralysis after the discontinuance of these drugs have most often involved aminosteroid-based NMBAs such as vecuronium bromide, especially when used in conjunction with corticosteroids. Atracurium besylate, a short-acting benzylisoquinolinium NMBA that is eliminated independently of renal or hepatic function, has also been associated with persistent paralysis, but only when used with corticosteroids. We report a case of atracurium-related paralysis persisting for approximately 50 hours in a patient who was not treated with corticosteroids.
authors.affiliation: Coastal Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA.
authors.forename: E R
authors.initials: ER
authors.lastname: Rubio
authors.forename: C B
authors.initials: CB
authors.lastname: Seelig
mesh_terms: D000305:Adrenal Cortex Hormones; D000328:Adult; D001279:Atracurium / Q000009:adverse effects*; D006801:Humans; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects*; D010243:Paralysis / Q000139:chemically induced*; D012121:Respiration, Artificial
chemical_list: D000305:Adrenal Cortex Hormones; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium