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Related Concept Videos

Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal 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...
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (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...
Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal 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.
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Related Experiment Videos

Decrease in functional residual capacity and ventilation homogeneity after neuromuscular blockade in anesthetized

Britta S von Ungern-Sternberg1, Adrian Regli, Franz J Frei

  • 1Division of Anesthesia, University Children's Hospital, Basel, Switzerland. bvonungern@uhbs.ch

Paediatric Anaesthesia
|August 9, 2007
PubMed
Summary

Neuromuscular blockade in children undergoing anesthesia in the lateral position decreased functional residual capacity (FRC). Applying positive end-expiratory pressure (PEEP) restored FRC and lung clearance index (LCI) to baseline levels.

Related Experiment Videos

Area of Science:

  • Pediatric Anesthesiology
  • Respiratory Physiology
  • Critical Care Medicine

Background:

  • Functional residual capacity (FRC) decreases in children under general anesthesia.
  • The lateral position increases FRC compared to the supine position.
  • The effect of neuromuscular blockade on FRC in the lateral position is unknown.

Purpose of the Study:

  • To test if neuromuscular blockade decreases FRC and increases lung clearance index (LCI) in children in the lateral position.
  • To determine if positive end-expiratory pressure (PEEP) of 6 cmH2O restores FRC and LCI.

Main Methods:

  • 18 preschool children (2-6 years) without cardiopulmonary disease were studied.
  • Anesthesia was standardized with propofol and fentanyl.
  • FRC and LCI were measured using SF6 multibreath washout in the lateral position (PEEP 3 cmH2O) after intubation, neuromuscular blockade, and additional PEEP (6 cmH2O).

Main Results:

  • Neuromuscular blockade significantly decreased FRC (31.6 to 27.6 ml.kg-1) and increased LCI (6.54 to 7.0).
  • Application of PEEP (6 cmH2O) increased FRC (to 32.4 ml.kg-1) and decreased LCI (to 6.58), restoring them to baseline levels.

Conclusions:

  • Neuromuscular blockade in the lateral position reduces FRC and increases ventilation inhomogeneity in children.
  • PEEP of 6 cmH2O effectively restores FRC and LCI to baseline in this setting.