Adverse Effects of Nondepolarising Neuromuscular Blocking Agents

Abel, Mark F.; Wj, Book; Jb, Eisenkraft

doi:10.2165/00002018-199410060-00002

Cited by 19 publications

(1 citation statement)

References 276 publications

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“…Nondepolarising blocking drugs will be discussed in the next issue of the Journal (Abel et al 1994). In 1954, Beecher and Todd reported that with the advent of neuromuscular blocking agents, anaesthesia-related mortality increased 6-fold.…”

Section: Discussionmentioning

confidence: 99%

Adverse Effects of Depolarising Neuromuscular Blocking Agents

1994

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Muscle relaxants block neuromuscular transmission, acting at nicotinic acetylcholine receptors of the neuromuscular junction. Suxamethonium (succinylcholine) is a depolarising agent, whereas all other relaxants in clinical use are nondepolarising. The desired neuromuscular block results from the structural similarity of muscle relaxants to acetylcholine, enabling the interaction with receptors at the neuromuscular junction. Adverse effects of suxamethonium are generally related to its agonist mode of action. Autonomic cardiovascular effects may result. Other adverse effects include anaphylactic or anaphylactoid reactions, and histamine release. Various disease states may present specific considerations in the use of muscle relaxants. Although many complications of muscle relaxants (such as prolonged block or resistance) are easily treated, others may require immediate intervention and vigorous therapy. Careful selection of appropriate relaxants for particular patients will usually prevent the occurrence of complications.

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Section: Discussionmentioning

confidence: 99%

Adverse Effects of Depolarising Neuromuscular Blocking Agents

1994

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Functional basis for dose-dependent antagonism of rat and rabbit neuromuscular transmission by the bis-pyridinium oxime MMB4

et al. 2020

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Adverse reactions to neuromuscular blocking agents

Mertès¹,

Laxenaire²

2004

Curr Allergy Asthma Rep

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Neuromuscular blocking agents (NMBAs) play a predominant role in the incidence of severe adverse reactions occurring during anesthesia. Most hypersensitivity reactions are of immunologic origin (IgE-mediated) or are related to direct stimulation of histamine release. The incidence of IgE-mediated hypersensitivity or anaphylaxis is estimated between 1 in 10,000 and 1 in 20,000 anesthesias, and NMBAs represent the most frequently involved substances, with a range of 50% to 70%. Any suspected anaphylactic reaction must be extensively investigated using combined perioperative and postoperative testing. Because of the frequent cross-reactivity observed with muscle relaxants, every available NMBA should be tested. This should help provide documented advice for future administration of anesthesia. There is no demonstrated evidence for systematic preoperative screening in the general population at this time. Other well-known adverse effects have been described, such as the succinylcholine-triggered cytotoxic effects on muscle cells, but these are responsible for characteristic clinical symptoms, which are usually easy to distinguish from anaphylactic reactions

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Adverse Effects of Nondepolarising Neuromuscular Blocking Agents

Cited by 19 publications

References 276 publications

Adverse Effects of Depolarising Neuromuscular Blocking Agents

Adverse Effects of Depolarising Neuromuscular Blocking Agents

Functional basis for dose-dependent antagonism of rat and rabbit neuromuscular transmission by the bis-pyridinium oxime MMB4

Adverse reactions to neuromuscular blocking agents

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