search for


 

Updated review of resistance to neuromuscular blocking agents
Anesth Pain Med 2018;13(2):122-7
Published online April 30, 2018
© 2018 The Korean Society of Anesthesiologists.

Ki Tae Jung and Tae Hun An
Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
Correspondence to: Tae Hun An, M.D.
Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Chosun University School of Medicine, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea
Tel: 82-62-220-3223
Fax: 82-62-223-2333
E-mail: than@chosun.ac.kr
ORCID
http://orcid.org/0000-0002-7405-0073
Received October 24, 2017; Revised November 21, 2017; Accepted November 21, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Since neuromuscular blocking agents (NMBAs) were introduced to the surgical field, they have become almost mandatory for the induction and maintenance of anesthesia. However, resistance to NMBAs can develop in certain pathological states, such as central nerve injury, burns, and critical illnesses. During such pathological processes, quantitative and qualitative changes occur in the physiology of acetylcholine and the acetylcholine receptor (AChR) at the neuromuscular junction. Up-regulation of AChR leads to changes in the pharmacokinetics and pharmacodynamics of NMBA. As NMBA resistance may result in problems during anesthesia, it is of utmost importance to understand the mechanisms of NMBA resistance and their associations with pathological status to maintain adequate neuromuscular relaxation. This review presents the current knowledge of pharmacokinetic and pharmacodynamic changes and pathological status associated with NMBA resistance.
Key Words : Cholinergic receptors, Drug resistance, Neuromuscular blocking agents, Upregulation.


April 2018, 13 (2)
Full Text(PDF) Free

Social Network Service
Services

Cited By Articles
  • CrossRef (0)

Funding Information