Effect Sites of Neuromuscular Blocking Agents and the Monitoring of Clinical Muscle Relaxation
The main goals of muscular relaxation during induction of anaesthesia are the paralysis of the vocal cords and jaw muscles to facilitate tracheal intubation and the relaxation of the respiratory muscles. Paralysis of the abdominal muscles and the diaphragm is often required intraoperatively, particularly during abdominal surgery. During recovery of neuromuscular blockade, restoration of complete skeletal muscular strength is essential to ensure adequate spontaneous ventilation and the permeability of the upper airway. For practical reasons, it is almost impossible to monitor the response of the respiratory or abdominal muscles during anaesthesia. Paton and Zaimis demonstrated in 1951 that respiratory muscles were more resistant to curare than other muscles.1 In humans, several studies have reported some discrepancies between the level of peripheral paralysis and respiratory depression or the intubating conditions.2,3 Therefore, both understanding and knowledge of the relationship between neuromuscular function at the monitored muscle and the other muscles are important in the interpretation of monitoring.
KeywordsVocal Cord Respiratory Muscle Neuromuscular Blockade Neuromuscular Block Effect Compartment
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