Novel drug development for neuromuscular blockade.
Pharmacological advances in anesthesia in recent decades have resulted in safer practice and better outcomes. These advances include improvement in anesthesia drugs with regard to efficacy and safety profiles. Although neuromuscular blockers were first introduced over a half century ago, few new neuromuscular blockers and reversal agents have come to market and even fewer have remained as common clinically employed medications. In recent years, newer agents have been studied and are presented in this review. With regard to nondepolarizer neuromuscular blocker agents, the enantiomers Gantacurium and CW002, which are olefinic isoquinolinium diester fumarates, have shown potential for clinical application. Advantages include ultra rapid reversal of neuromuscular blockade via cysteine adduction and minimal systemic hemodynamic effects with administration.
Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Amit
A
Prabhakar
Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Alan D
AD
Kaye
Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Melville Q
MQ
Wyche
Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Orlando J
OJ
Salinas
Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Kenneth
K
Mancuso
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Richard D
RD
Urman
Anesthesia; CW002; gantacurium; neuromuscular blocker; nondepolorizer blocker