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Highlights in muscle relaxants
Yigal Leykin1, Tommaso Pellis, Ezio Vincenti
1Santa Maria degli Angeli Hospital, Department of Anesthesia and Intensive Care, Via Montereale 24, 33170 Pordenone, Italy. yigal.leykin@aopn.fvg.it
Expert Review of Neurotherapeutics
|December 22, 2006
Summary
Selecting appropriate neuromuscular blocking agents for anesthesia is crucial for patient safety and cost-effectiveness. Careful consideration of pharmacological and economic factors ensures optimal outcomes and smooth surgical procedures.
Area of Science:
- Anesthesiology and Pharmacology
Background:
- Neuromuscular blocking agents are essential in anesthesia for endotracheal intubation and surgical paralysis.
- The field sees continuous development of new agents, often with increased costs.
Purpose of the Study:
- To provide an overview of neuromuscular blocking agents.
- To guide rational selection based on pharmacological and pharmacoeconomic factors.
- To discuss neuromuscular blockers and their antagonists.
Main Methods:
- Review of current literature on neuromuscular blocking agents.
- Analysis of pharmacological properties and pharmacoeconomic considerations.
- Discussion of selection criteria for anesthetic practice.
Main Results:
- Appropriate selection can reduce complication costs and improve operating room efficiency.
- New agents offer improvements in safety, duration, and side effect profiles.
- Anesthesia drugs are non-therapeutic, complicating direct outcome assessment.
Conclusions:
- Rational selection of neuromuscular blocking agents balances efficacy, safety, and cost.
- Pharmacoeconomic evaluation is vital for managing anesthesia-related drug expenditures.
- Ongoing research and development aim to enhance agent performance and patient safety.
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01:21Skeletal Muscle Relaxants: Adverse Effects
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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...
01:09Peripherally and Centrally Acting Muscle Relaxants: A Comparison
Skeletal muscle relaxants can target the central nervous system [CNS] to reduce muscle tension or act directly at the neuromuscular junction to induce temporary paralysis. These two classes of muscle relaxants are called centrally acting muscle relaxants and peripherally acting muscle relaxants. They differ in their action, mechanism, administration route, and clinical uses.
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic drugs,...
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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...
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01:24Centrally Acting Muscle Relaxants: Therapeutic Uses
Centrally acting muscle relaxants reduce muscle tone and tension by interfering with the postsynaptic reflexes in the central nervous system.
Centrally acting drugs are classified into spasmolytic and antispasmodic drugs. Spasmolytic drugs such as baclofen, diazepam, and tizanidine inhibit spinal motor neurons and decrease muscle tone. Spasmolytic drugs are administered for severe and chronic spasms due to multiple sclerosis, cerebral palsy, stroke, and spinal cord and muscle injuries. However,...
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01:26Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
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The binding of dantrolene to the RYR1...
The binding of dantrolene to the RYR1...