Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Ventilation and neuromuscular blocking drugs

L I Eriksson1

  • 1Department of Anaesthesiology and Intensive Care, Karolinska Hospital, Stockholm, Sweden.

Acta Anaesthesiologica Scandinavica. Supplementum
|January 1, 1994
PubMed
Summary

Neuromuscular blocking agents can cause dangerous ventilatory failure. Standard monitoring may not detect residual paralysis, impacting respiratory function and airway control, especially during hypoxemia.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Evaluation of Genetic or Cellular Impairments in Type I IFN Immunity in a Cohort of Young Adults with Critical COVID-19.

Journal of clinical immunology·2024
Same author

Hypoxic ventilatory response after rocuronium-induced partial neuromuscular blockade in men with obstructive sleep apnoea.

Anaesthesia·2019
Same author

Prolonged attenuation of acetylcholine-induced phosphorylation of extracellular signal-regulated kinase 1/2 following sevoflurane exposure.

Acta anaesthesiologica Scandinavica·2012
Same author

Breathing and swallowing in normal man--effects of changes in body position, bolus types, and respiratory drive.

Neurogastroenterology and motility·2010
Same author

Swallowing and respiratory pattern in young healthy individuals recorded with high temporal resolution.

Neurogastroenterology and motility·2009
Same author

Current concepts in neuromuscular transmission.

British journal of anaesthesia·2009

Area of Science:

  • Anesthesiology
  • Respiratory Physiology

Background:

  • Neuromuscular blocking agents (NMBAs) are crucial in anesthesia but can lead to postoperative ventilatory failure.
  • Incomplete recovery of neuromuscular function is a significant cause of anesthesia-related morbidity and mortality.

Purpose of the Study:

  • To highlight the limitations of current neuromuscular monitoring methods.
  • To emphasize the importance of comprehensive assessment for safe recovery from NMBAs.

Main Methods:

  • Review of existing literature on neuromuscular blockade and ventilatory control.
  • Analysis of the differential effects of NMBAs on central and peripheral respiratory muscles.
  • Comparison of train-of-four (TOF) response with hypoxic ventilatory response.

Main Results:

  • Central respiratory muscles exhibit different sensitivity and recovery patterns compared to peripheral muscles (e.g., adductor pollicis).
  • A train-of-four (TOF) ratio of 0.70, previously considered adequate, may not guarantee sufficient hypoxic ventilatory response.
  • Residual neuromuscular blockade can impair ventilatory regulation, particularly during hypoxemia.

Conclusions:

  • Current peripheral neuromuscular monitoring provides limited insight into overall ventilatory capacity and upper airway function.
  • Caution is advised when relying solely on peripheral nerve stimulation for assessing recovery from NMBAs.
  • Integrating bedside clinical tests with neuromuscular monitoring is essential for a comprehensive evaluation of ventilatory function.

Related Experiment Videos