Neuromuscular block and current treatment strategies for its reversal in children.
Even though neuromuscular blocking agents are an essential part of balanced anesthesia and the risks of residual paralysis are well documented, many anesthetists seldomly monitor neuromuscular block. Classical reversal agent neostigmine is unable to antagonise a deep neuromuscular block and is rather slow to antagonise even a moderate block. These caveats may have introduced a practice to use muscle relaxants mainly for an endotracheal intubation. This review presents current views on the effects of muscle relaxants and their reversal agents in pediatric patients. This may help clinicians to reconsider the value of muscle relaxants during anesthesia in children.
Meretoja
Olli A
OA
Department of Anaesthesiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. olli.meretoja@hus.fi
D000762:Anesthesia Recovery Period; D002648:Child; D002675:Child, Preschool; D002800:Cholinesterase Inhibitors; D006801:Humans; D007223:Infant; D009388:Neostigmine; D019148:Neuromuscular Blockade / Q000379:methods*; D010372:Pediatrics / Q000379:methods; D000077122:Sugammadex; D047408:gamma-Cyclodextrins
D002800:Cholinesterase Inhibitors; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D009388:Neostigmine