Advertisement

Neuromuscular Blockers

  • Gabriel Goodwin
  • Vilma Joseph
Chapter

Abstract

Muscle relaxants were first used on poisonous darts by South American Indians during hunting, according to accounts found in the court of King Ferdinand and Queen Isabella. It took several hundred years until their therapeutic potential was realized in the medical setting. Tubocurarine, the first muscle relaxant used clinically, often produced hypotension and tachycardia through histamine release. Today, we have sophisticated neuromuscular blockers (NMBs) that keep the patient paralyzed providing ideal surgical conditions, facilitating intubation and artificial ventilation, with minimal changes to vital signs.

Keywords

Malignant Hyperthermia Malignant Hyperthermia Rapid Sequence Induction Double Burst Stimulation Autosomal Dominant Genetic Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

References

  1. 1.
    Thandla R. Neuromuscular blocking drugs: discovery and development. J R Soc Med. 2002;95(7):363–7.CrossRefGoogle Scholar
  2. 2.
    Morgan GE, Mikhail MS, Murray MJ. Clinical Anesthesiology. 4th ed. New York: McGraw-Hill Companies, Inc; 2006.Google Scholar
  3. 3.
    Miller R, Eriksson L, Fleisher L, Wiener-Kronish J, Young W. Miller’s Anesthesia. 7th ed. Churchill Livingstone: Elsevier; 2009.Google Scholar
  4. 4.
    Waud BE, Waud DR. The relation between the response to “train-of-four” stimulation and receptor occlusion during competitive neuromuscular block. Anesthesiology. 1972;37(4):413–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Thilen SR, Hansen BE, Ramaiah R, Kent CD, Treggiari MM, Bhananker SM. Intraoperative neuromuscular monitoring site and residual paralysis. Anesthesiology. 2012;117(5):964–72.PubMedCrossRefGoogle Scholar
  6. 6.
    Kim DC. Malignant hyperthermia. Kor J Anesthesiol. 2012;63(5):391–401.CrossRefGoogle Scholar
  7. 7.
    FDA (last updated 1/24/2013). Drugs to be discontinued. http://www.fda.gov/drugs/drugsafety/drugshortages/ucm050794.htm.
  8. 8.
    Stuckmann N, Schwering S, Wiegand S, Gschnell A, Yamada M, Kummer W, Wess J, Haberberger R. Role of muscarinic receptor subtypes in the constriction of peripheral airways: studies on receptor-deficient mice. Mol Pharmacol. 2003;64(6):1444–51.CrossRefGoogle Scholar
  9. 9.
    Padmaja D, Mantha S. Monitoring of neuromuscular junction. Indian J Anaesth. 2002;46(4):279–88.Google Scholar
  10. 10.
    Barash P, Cullen B, Stoelting R, Cahalan M, Stock C, Ortega R. Clinical anesthesia. 7th ed. Philadelphia: Lippincott; 2013.Google Scholar
  11. 11.
    Jooste E, Klafter F, Hirshman CA, Emala CW. A mechanism for rapacuronium-induced bronchospasm: M2 muscarinic receptor antagonism. Anesthesiology. 2003;98(4):906–11.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of AnesthesiologyMontefiore Medical Center, Albert Einstein College of MedicineBronxUSA

Personalised recommendations