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Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

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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...
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Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers01:27

Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers

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β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
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Sympathetic Signaling01:31

Sympathetic Signaling

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Sympathetic signaling, a vital part of the autonomic nervous system, plays a crucial role in mobilizing the body's resources in response to stress or emergencies. It involves the transmission of nerve impulses from sympathetic preganglionic fibers to postganglionic fibers. This results in the release of specific neurotransmitters and activation of adrenergic receptors.
Sympathetic preganglionic fibers release the neurotransmitter acetylcholine (ACh) onto the ganglionic neurons in the...
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Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
523
Drugs Acting on Autonomic Ganglia: Blockers01:28

Drugs Acting on Autonomic Ganglia: Blockers

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Ganglionic blockers inhibit autonomic activity by blocking nicotinic receptors in the autonomic ganglia, suppressing impulse transmission. These blockers lack selectivity between sympathetic and parasympathetic ganglia and are ineffective as neuromuscular junction antagonists. They can be categorized into two groups:
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Related Experiment Video

Updated: Oct 28, 2025

Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy
03:59

Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy

Published on: January 10, 2019

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Thoracoscopic sympathetic block to predict compensatory hyperhidrosis in primary hyperhidrosis.

June Lee1, Jin Yong Jeong1, Jong Hui Suh1

  • 1Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Journal of Thoracic Disease
|July 19, 2021
PubMed
Summary

Thoracoscopic sympathetic nerve block accurately predicts compensatory hyperhidrosis after sympathectomy for primary hyperhidrosis. This safe procedure helps patients decide on surgery by simulating sympathectomy effects.

Keywords:
Hyperhidrosiscompensatory hyperhidrosis (CH)sympathectomysympathetic blockvideo-assisted thoracoscopic surgery (VATS)

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Author Spotlight: Exploring Plasticity of Sympathetic Neurons
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Author Spotlight: Exploring Plasticity of Sympathetic Neurons

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Ethanol-Induced Cervical Sympathetic Ganglion Block Applications for Promoting Canine Inferior Alveolar Nerve Regeneration Using an Artificial Nerve
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Ethanol-Induced Cervical Sympathetic Ganglion Block Applications for Promoting Canine Inferior Alveolar Nerve Regeneration Using an Artificial Nerve

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Last Updated: Oct 28, 2025

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Author Spotlight: Exploring Plasticity of Sympathetic Neurons
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Ethanol-Induced Cervical Sympathetic Ganglion Block Applications for Promoting Canine Inferior Alveolar Nerve Regeneration Using an Artificial Nerve
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Ethanol-Induced Cervical Sympathetic Ganglion Block Applications for Promoting Canine Inferior Alveolar Nerve Regeneration Using an Artificial Nerve

Published on: November 30, 2018

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Area of Science:

  • Neurosurgery
  • Thoracic Surgery
  • Dermatology

Background:

  • Compensatory hyperhidrosis is a primary concern for patients post-sympathectomy.
  • Thoracoscopic sympathetic nerve block offers a predictive method for post-sympathectomy compensatory hyperhidrosis.
  • This study reviews the efficacy, safety, and validity of this nerve block procedure.

Purpose of the Study:

  • To evaluate the effectiveness of thoracoscopic sympathetic nerve block in predicting compensatory hyperhidrosis.
  • To assess the safety and feasibility of the nerve block procedure.
  • To guide patient decisions regarding sympathectomy for primary hyperhidrosis.

Main Methods:

  • Retrospective review of 107 patients undergoing thoracoscopic sympathetic nerve block for primary palmar and craniofacial hyperhidrosis.
  • Utilized a 2-mm needlescope for the nerve block procedure.
  • Analyzed patient data, including interviews and decisions on proceeding with sympathectomy.

Main Results:

  • The nerve block effectively relieved primary hyperhidrosis without severe complications.
  • Compensatory hyperhidrosis occurred in 29.9% of patients post-nerve block.
  • The procedure demonstrated 94.4% specificity and 33.3% sensitivity for predicting compensatory hyperhidrosis.
  • A longer effective block duration correlated with a decision to proceed with sympathectomy.

Conclusions:

  • Thoracoscopic sympathetic block is a safe and feasible method for predicting compensatory hyperhidrosis.
  • The procedure allows patients to experience potential outcomes of sympathectomy.
  • Extended effective block duration is crucial for informed surgical decision-making.