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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Seminars in Anesthes...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Seminars in Anesthesia Perioperative Medicine and Pain
Article . 2002 . Peer-reviewed
License: Elsevier TDM
Data sources: Crossref
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Reversal agents for nondepolarizing neuromuscular blockade: Reasons for and development of a new concept

Authors: Leo H.D.J. Booij; Hans D. de Boer; Jan van Egmond;

Reversal agents for nondepolarizing neuromuscular blockade: Reasons for and development of a new concept

Abstract

T HE INTRODUCTION of muscle relaxants into clinical anesthesia had an enormous impact on the possibilities of the surgical treatment of patients. The development of cleaner and shorteracting nondepolarizers with a benzylisoquinoline or a steroidal chemical structure further improved clinical anesthesia. However, their introduction coincided with a relatively high morbidity and mortality rate compared with anesthetic techniques when relaxants are not administered. 1 This is mainly caused by the occurrence of postoperative residual curarization, resulting in hypoxemia and airway obstruction. 2'3 Although the incidence of residual curarization with the newer intermediately short-acting and short-acting relaxants is lower than with the older long-acting relaxants, it still poses a problem. 4 The nondepolarizing relaxants still do not have a fast onset of action combined with a short duration of action. When a rapid onset is needed, a high dose is needed, causing a prolonged neuromuscular blockade, frequently outlasting the duration of surgery. Besides, a long duration of action may also cause a problem in the rare situation of "cannot intubate, cannot ventilate," which requires immediate restoration of spontaneous ventilation. In the clinical situation, an unexpected long duration of action of nondepolarizing relaxants may occur caused by an interaction with other drugs or by concurrent diseases present in the patient. With the current muscle relaxants, the possibility to reverse neuromuscular blockade thus remains important. For legal reasons, many anesthetists do routinely reverse neuromuscular blockade. 5 However, with the current reversal agents, this only provides an unjustified

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
19
Average
Top 10%
Average
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