[Muscle relaxants in ambulatory anesthesia].
Neuromuscular blocking agents are used to facilitate tracheal intubation and surgical procedure in ambulatory anesthesia. However, the ideal neuromuscular blocking agents for ambulatory anesthesia are not yet available. The only depolarizing neuromuscular blocking agent, suxamethonium, is still widely used by its rapid onset and short duration of action producing excellent intubating conditions, in spite of its numerous adverse effects. Nondepolarizing neuromuscular agents have proved to be associated with postoperative residual block more frequently than it was thought before. The use of neostigmine for reversal and the measurement of the TOF ratio during recovery are recommended after intermediate-acting neuromuscular blocking agents. Some studies have shown that tracheal intubation without neuromuscular agents may be associated with postoperative hoarseness and vocal cord injuries. Sugammadex will resolve many issues in using nondepolarizing neuromuscular agents in ambulatory anesthesia.
Takeda
Junzo
J
Department of Anesthesiology, School of Medicine, Keio University, Tokyo 160-8582.
D000556:Ambulatory Surgical Procedures; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D007442:Intubation, Intratracheal; D016343:Monitoring, Intraoperative; D009388:Neostigmine / Q000008:administration & dosage / Q000494:pharmacology; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage* / Q000009:adverse effects* / Q000037:antagonists & inhibitors; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D011183:Postoperative Complications / Q000517:prevention & control; D000077122:Sugammadex; D014827:Vocal Cords / Q000293:injuries; D047408:gamma-Cyclodextrins
D002800:Cholinesterase Inhibitors; D009466:Neuromuscular Blocking Agents; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D009388:Neostigmine