Persistent paralysis after prolonged use of atracurium in the absence of corticosteroids.
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.
Rubio
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ER
Coastal Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA.
Seelig
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CB
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
D000305:Adrenal Cortex Hormones; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium