Factors involved in prolonged effect of neuromuscular blockade in therapeutic hypothermia

Therapeutic hypothermia (TH) following out-of-hospital cardiac arrest (OHCA) improves neurological outcomes in such patients. During TH, neuromuscular blockade is used to control shivering in the patient. In our hospital, we use vecuronium as a neuromuscular blocker. However, occasionally, prolonged effects of vecuronium delay accurate evaluation of patients' neurological function or extubation. Unfortunately, the factors involved in the prolonged effect of vecuronium in TH remain unclear.