Emergency Medicine

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Title: NMBs in intubated patients

Category: Critical Care

Posted: 3/3/2009 by Mike Winters, MBA, MD (Updated: 3/3/2026)

Neuromuscular Blocking Agent (NMBA)

  • NMBAs are used to facilitate intubation when performing RSI
  • Importantly, NMBAs have no analgesic or amnestic effects
  • Indiscriminate and repeated dosing of NMBA can lead to prolonged recovery and critical illness polyneuromyopathy, a devastating complication of critical illness that prolongs ventilation, ICU/hospital length of stay, and increases mortality
  • Take Home Point: provide adequate amounts of sedation and analgesia to your intubated ED patients rather then reflexively giving repeated doses of NMBA