A Blueprint for a Fast Acting Non-Depolarizing Drug
Ideally, the anesthesiologist should have a non-depolarizing muscle relaxant with an onset time of one minute or less, and a duration no greater than 5–10 min, so that the risk of aspiration of gastric contents is minimized, and alternate plans can be worked out if tracheal intubation is not successful. So far, only succinylcholine has such an ideal neuromuscular profile. This situation is not due to the depolarizing nature of succinylcholine block, but to a combination of pharmacokinetic and pharmacodynamic factors which have not been met with non-depolarizing neuromuscular blockade. To obtain fast onset and rapid recovery, peak drug levels should be reached rapidly at the neuromuscular junction, these levels should be adequate for blockade, and the drug should be cleared rapidly.
KeywordsOnset Time Neuromuscular Junction Fast Onset Adductor Pollicis Orbicularis Oculus
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