To the Editor:—We read with interest article by Jonsson et al. suggesting that nondepolarizing neuromuscular blocking agents concentration-dependently inhibit human neuronal acetylcholine autoreceptors (nAChRs). The authors argue that the inhibition of the presynaptic 3 2 nAChR subtype plays an important role in tetanic and train-of-four fade seen during nondepolarizing neuromuscular blockade. ...

To the Editor:—We read with interest article by Jonsson et al. suggesting that nondepolarizing neuromuscular blocking agents concentration-dependently inhibit human neuronal acetylcholine autoreceptors (nAChRs). The authors argue that the inhibition of the presynaptic 3 2 nAChR subtype plays an important role in tetanic and train-of-four fade seen during nondepolarizing neuromuscular blockade. ...

Neuromuscular blocking agents are frequently used in the Intensive Care Unit to facilitate tracheal intubation and the application of continuous paralysis. This review will focus on various conditions of the critically ill patient such as multi-organ dysfunction, acid-base and electrolyte imbalance, prolonged immobility, multiple drug interactions and specific disease/injury processes that may ...

Introduction. Maintenance dosing of neuromuscular blocking agents is complex and varies with patient, procedure, and clinical situation. With this in mind, we sought to identify factors impacting the maintenance dosing of neuromuscular blockers as a step toward identifying best practice with respect to minimizing residual neuromuscular blockade. Methods. Cases utilizing rocuronium from July 1, ...

Neostigmine failed to modify the development of neuromuscular block in the presence of a high local concentration of tubocurarine. Only when the concentration of tubocurarine was reduced, and a suitable concentration gradient established between the receptor area and the plasma, did neostigmine increase the rate of recovery from the action of non-depolarizing neuromuscular blocking agents.

This systematic review describes the evidence on the use of acceleromyography for perioperative neuromuscular monitoring in clinical practice and research. The review documents that although acceleromyography is widely used in research, it cannot be used interchangeably with mechanomyography and electromyography for construction of dose-response curves or for recording different pharmacodynamic...

Sedation is used almost universally in the care of critically ill patients, especially in those who require mechanical ventilatory support or other life-saving invasive procedures. This review will focus on the sedation strategies for critically ill patients and the pharmacology of commonly used sedative agents. The role of neuromuscular blocking agents in the ICU will be examined and the pharm...

To the Editor:—Schreiber et al. noted an association between larger doses of succinylcholine and a reduced incidence of fasciculation and myalgia. However, pretreatment with a nondepolarizing neuromuscular blocker is also associated with a reduced risk of fasciculation and myalgia. It is a common practice for clinicians to use a larger dose of succinylcholine when they have provided pretreatmen...

AN initial transient increase in the size of the muscle twitch before the onset of paralysis has been described as characteristic following the intravenous injection of a depolarizing neuromuscular blocking agent. During several series of experiments undertaken in the study of different aspects of neuromuscular block this typical response was confirmed, but it was also noted that occasionally a...

To the Editor:—Schreiber et al. noted an association between larger doses of succinylcholine and a reduced incidence of fasciculation and myalgia. However, pretreatment with a nondepolarizing neuromuscular blocker is also associated with a reduced risk of fasciculation and myalgia. It is a common practice for clinicians to use a larger dose of succinylcholine when they have provided pretreatmen...