Limited professional guidance and literature are available to guide the safe use of neuromuscular block in infants.

Abstract

AIM:

Neuromuscular blocking agents (NMBAs) are used in a range of critical illnesses in neonates and infants, despite a lack of guidelines and professional standards. This study reviewed the current evidence base and ascertained UK practice regarding the continuous use of these agents in this age range.

METHODS:

We reviewed the literature and carried out a telephone questionnaire of all tertiary units in England and specialist children's hospital neonatal units in the UK.

RESULTS:

No best practice guidelines or general consensus statements were found, and the only randomised trial to feature an NMBA protocol expressed concerns about its use in such young babies. Of the 56 units contacted, 54 (96.4%) shared information. Only three of the 56 (5.4%) used intermittent boluses of NMBAs, 91.1% used NMBA infusions, 11 (19.6%) routinely used regular neuromuscular blocker pause to assess depth, and only one (1.8%) used peripheral nerve stimulation monitoring. All the units carried out clinical assessments, but only one (1.8%) had a written protocol.

CONCLUSION:

There is a paucity of literature and professional standards to guide the safe use of NMBAs in infants. Of the 54 units who participated in the survey, only one had a protocol for using NMBAs in babies.

• Authors: Maik Honsel, Cristina Giugni, Joe Brierley
• Journal: Acta paediatrica (Oslo, Norway : 1992) (Acta Paediatr) Vol. 103 Issue 9 Pg. e370-3 (Sep 2014) ISSN: 1651-2227 [Electronic] Norway
• PMID: 24813671 (Publication Type: Journal Article, Review)
• Copyright: ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Chemical References

• Neuromuscular Blocking Agents

Topics

• Humans
• Infant
• Neuromuscular Blockade (standards)
• Neuromuscular Blocking Agents
• Pediatrics
• Practice Guidelines as Topic
• Practice Patterns, Physicians'
• Surveys and Questionnaires
• United Kingdom