Fear of Neuromuscular Blocking Drugs (NMBD’s)? Let It Go, Let It Go? From Poison Arrows to Modern Day Paralytic Anesthesia

Keynote Speaker – Dr. Scott Adrian, DVM
Principal Veterinarian – Charles River Laboratories, Safety Assessment
Mattawan, MI

For decades, the words “paralytics and neuromuscular blocking drugs” have stricken fear into hearts of IACUCs and animal researchers alike. As if just uttering the words would immediately summon the “demons of a regulatory inspection”.  Obviously, these fears have a basis in legitimate animal welfare concerns, and an animal should never be unjustifiably subjected to pain, distress, or discomfort without analgesic compensation and the ability to communicate that suffering should our mitigation efforts prove inadequate.  Besides the significant physiologic and anesthetic properties that must be considered when using paralytic agents, we also tend to introduce anthropomorphized phobias of their use with the terror of being “buried alive” and Locked-in Syndrome. Worse yet, these concerns are not only based on imagined fears, but first-hand accounts by persons who have survived conditions of complete paralysis with intact consciousness. So yes, there are legitimate and significant concerns and precautions that must be accounted for when proposing the use of NMBDs in an animal’s anesthetic procedure. However, as with most things in life, with proper education, preparation, and the benefits of modern medical science we can safely and effectively incorporate these agents into a well-designed balanced anesthetic protocol when their use justifiably benefits the research, surgeon, and patient. Let us see if we can overcome our fear of being “frozen” by learning a bit more about the modern science of neuromuscular blocking drugs and the paralysis they produce.