Related Experiment Video
Updated: Jul 19, 2026
08:50
Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
Published on: June 25, 2013
Do we need muscular blockers in ambulatory anaesthesia?
1University Department of Anesthesia, University of Liverpool, UK. mleuwer@liv.ac.uk
Current Opinion in Anaesthesiology
|October 4, 2006
Summary
The laryngeal mask airway enables safe anesthesia for most day surgery patients without muscle relaxants. Modern non-depolarizing agents are preferred for relaxation, while succinylcholine is best reserved for emergency intubations.
Area of Science:
- Anesthesiology
- Airway Management
Background:
- The laryngeal mask airway (LMA) has revolutionized anesthesia practices.
- Many day case procedures can now be performed without muscle relaxants.
Purpose of the Study:
- To review anesthetic techniques for day case patients.
- To discuss appropriate muscle relaxant choices when needed.
Main Methods:
- Review of current anesthetic practices and drug choices.
- Discussion of indications for muscle relaxant use.
Main Results:
- The majority of day case patients do not require muscle relaxants with LMA use.
- Modern non-depolarizing neuromuscular blocking agents are suitable for elective muscle relaxation.
- Succinylcholine is primarily indicated for emergency intubation, particularly in pediatric patients.
Conclusions:
- Anesthesia without muscle relaxants is feasible for most day surgery patients using the LMA.
- Vecuronium, rocuronium, atracurium, cisatracurium, and mivacurium are recommended for non-emergency muscle relaxation.
- Succinylcholine use should be limited to emergency airway management scenarios.
More Related Videos
Related Concept Videos
01:27Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Although all competitive neuromuscular blockers are designed...
01:31Skeletal Muscle Relaxants: Therapeutic Uses
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
01:28Classification of Skeletal Muscle Relaxants
Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
01:21Skeletal Muscle Relaxants: Adverse Effects
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
01:11Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics
All neuromuscular blocking agents are injected intravenously because they are poorly absorbed from the GI tract. Rapid onset is achieved with intravenous administration, although absorption is also adequate from an intramuscular injection. Since these agents are highly ionized, they do not readily penetrate cell membranes or cross the blood-brain barrier.
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
01:17Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action
Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...