Axonal motor neuropathy associated with the use of neuromuscular blocking agents

A number of reports (lB.O]tO.D..J996) have associated the use of neuromuscular blocking agents, particularly vecuronium or pancuronium bromide, with the development of polyneuropathy. These drugs are used to ease mechanical ventilation. The clinical features are similar to critical illness polyneuropathy. In our opinion, this is simply a variant of that condition, with sepsis as an important underlying factor. The practical implications are that these neuromuscular blocking agents should be used as sparingly as possible, and should be promptly discontinued if there are signs of a polyneuropathy. Like critical illness polyneuropathy, the prognosis for recovery is good.

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