The Massachusetts General Hospital Handbook of Neurology

Authors: Flaherty, Alice W.; Rost, Natalia S.

Title: Massachusetts General Hospital Handbook of Neurology, The, 2nd Edition

Copyright 2007 Lippincott Williams & Wilkins

> Table of Contents > Drugs > Paralytics

Paralytics

A. Pupils are spared

Large pupils in a pt given paralytics are usually evidence of anxiety from inadequate sedation.

B. Succinylcholine

1-1.5 mg/kg IV bolus (typically 3.5-5 cc/70 kg of 20 mg/cc solution), onset 60-90 sec, lasts 3-10 min. Infusion 2.5-15 mg/min. A depolarizing blocker that can cause autonomic stimulation and raise intracranial pressure. Blunt this by pretreating with pancuronium (nondepolarizing) 1 mg IV, 5 min before succinylcholine.

C. Vecuronium

0.07-0.1 mg/kg IV bolus (typically 8-10 mg/70 kg), 2-3 min onset, lasts 15-30 min. Nondepolarizing.