Muscle relaxants and reversal agents

This article has discussed the anatomy and physiology of the neuromuscular junction and excitation-contraction coupling. The pharmacokinetics and pharmacodynamics of various depolarizing and nondepolarizing neuromuscular blocking agents were presented. Techniques of reversal and the need for concomitant administration of anticholinergics were discussed. Assessment of the postoperative patient, including types of neuromuscular blockade, criteria for successful extubation, and drugs and physiologic states that could prolong neuromuscular blockade were outlined. Because the recovery room nurse is relied on for continuous assessment of the postoperative patient, it is imperative that the nurse have a comprehensive knowledge of intraoperative factors that relate to the patient's recovery. The recovery room nurse should be an expert in the assessment of postoperative patients.