Neuromuscular blocking agents are used to facilitate tracheal intubation in patients undergoing ambulatory surgery. The use of high-dose neuromuscular blocking agents to achieve muscle paralysis throughout the case carries an increased risk of residual post-operative neuromuscular blockade, which is associated with increased respiratory morbidity. Visually monitoring the train-of-four (TOF) fad...

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, ...

Neuromuscular blocking agents suppress central respiratory activity through their inhibitory effects on preinspiratory neurons and the synaptic drive from preinspiratory neurons to inspiratory neurons. Central CO2-chemosensitive areas, which partly consist of CO2-excited neurons, in the rostral ventrolateral medulla are thought to provide tonic drive to the central respiratory network and invol...

OBJECTIVE To determine whether use of intermediate acting neuromuscular blocking agents during general anesthesia increases the incidence of postoperative respiratory complications. DESIGN Prospective, propensity score matched cohort study. SETTING General teaching hospital in Boston, Massachusetts, United States, 2006-10. PARTICIPANTS 18,579 surgical patients who received intermediate ac...

©International Anesthesia Research Society. Unauthorized Use Prohibited. Almost thirty years ago, residual neuromuscular blockade was documented in a surprisingly high proportion of patients (30%), despite an almost systematic use of anticholinesterase agents.1 Since then, even with the development of shorter-acting neuromuscular blockers, pharmacological reversal, and more widespread use of ne...

The author provides a review of the mechanism of neuromuscular transnission, as well as the Nechanisn of action and differences between curare and succinylcholine. Effects of these two relaxants on various organs and tissues are discussed, as are their onset of action, duration, elimination, and clinical uses. In order to understand how skeletal muscle re-laxants act, the mechanism of neuromusc...

The clinical pharmacology of neuromuscular blocking agents is described. During neuromuscular blockade, succinylcholine attaches to receptors in the motor end plate and depolarizes the neuromuscular junction, making the end plate refractory to acetylcholine. The nondepolarizing relaxants have a structure similar to that of succinylcholine and bind to the same receptors. Instead of depolarizing ...