[Muscle relaxation 2026-50 years of searching for the ideal relaxant]

Since its clinical introduction, muscle relaxation has been one of the most specific topics in anesthesiology, due to the clear interaction between physiology and pharmacology and the immediately apparent effects.Beyond the classical indications in anesthesia for securing the airway, many modern surgical procedures and interventions would not be possible without the development of muscle relaxation; however, warnings about the associated risks and complications have also been issued for decades.Following the expiration of the patent protection of sugammadex in summer 2023, its specific effects and favorable side-effect profile have made a significant contribution to the simplification of muscle relaxation management; however, nearly 2 years later it is important to acknowledge that this advantageous development does not guarantee complete safety and that clinical risks continue to exist in connection with muscle relaxation.Therefore, in this field profound physiological and pharmacological knowledge stay just as important as a consistent and thorough work ethic in accordance with the current guidelines of the anesthesia professional associations.