Neostigmine has been traditionally used as the agent of choice to reverse Neuromuscular Blockade (NMB) after muscle paralysis during general anesthesia. However, the use of neostigmine has not been without untoward events. Sugammadex is a novel drug that selectively binds to aminosteroid nondepolarizing muscle relaxants and reverses even a deep level of NMB. Controversy exists regarding the opt...

BACKGROUND AND OBJECTIVES Neuromuscular blockers (NMB) have been used for more than half of a century in anesthesia and have always been a challenge for anesthesiologists. Until recently, the reversal of nondepolarizing neuromuscular blockers had only one option: the use of anticholinesterase agents. However, in some situations, such as deep neuromuscular blockade after high doses of relaxant, ...

To the Editor:—We read with interest article by Jonsson et al. suggesting that nondepolarizing neuromuscular blocking agents concentration-dependently inhibit human neuronal acetylcholine autoreceptors (nAChRs). The authors argue that the inhibition of the presynaptic 3 2 nAChR subtype plays an important role in tetanic and train-of-four fade seen during nondepolarizing neuromuscular blockade. ...

• Neuromuscular blocking agents (NMBAs) are often administered during surgical procedures to provide muscle relaxation and prevent patient movement, which may increase the risk of surgical complications • When neuromuscular block no longer needs to be maintained, patients may either be allowed to spontaneously recover neuromuscular function or be administered a reversal agent for more rapid rec...

BACKGROUND Calcium Channel Blockers (CCBs) are now widely employed in the treatment of cardiovascular diseases and peri operative hypertension. It has been reported that calcium channel blockers inhibit neuromuscular transmission. They have been shown to increase the neuromuscular blockade produced by neuromuscular blocking agents in in-vitro muscle nerve preparations. The present study is unde...

To the Editor:—We read with interest article by Jonsson et al. suggesting that nondepolarizing neuromuscular blocking agents concentration-dependently inhibit human neuronal acetylcholine autoreceptors (nAChRs). The authors argue that the inhibition of the presynaptic 3 2 nAChR subtype plays an important role in tetanic and train-of-four fade seen during nondepolarizing neuromuscular blockade. ...

The residual effects of neuromuscular blocking agents may persist into the early postoperative recovery period, even when neuromuscular blockade is carefully monitored and reversed in the operating room. Recent data suggest that mild degrees of residual paresis (train-of-four TOF ratios of 0.7-0.9) may be associated with significant impairment of respiratory and pharyngeal muscle function. Ther...