10/18/2013 ee ae Muscle Relaxants (Neuromuscular Blocking Drugs) Jenga, MLKes, Spm. Departement of tof Ancutesiology & Reanimation Dr Saif Anwar Hospital Broviiara University alana ecowenas ee Muscle Relaxants [~~ The pnp parmcsogicetet of neuroma ‘acing drat terra aremiaon of meeps ‘the nevomieaar junction” |" asanncs to general anestets10/18/2013 Key Concepts Muscle relaxation does not ensure ‘unconsciousness, amnesia, or analgesia “ Depolarizing muscle relaxants act as ‘acetylcholine (ACh) receptor agonists, whereas ‘nondepolarzing muscle relaxants function as. competitive antagonists “+ Depolarzing muscle relaxants are hydrolyzed in the plasma and liver by pseudocholinesterase “ Succinylcholine is considered contraindicated inthe routine management of children and adolescents because of the risk of hyperkalemia, thabdomyolysis, and cardiac arrest in children with undiagnosed myopathies. “+ Succinylcholine induced depolarization to raise serum potassium by 0.5 mEq/L. Doxacurium, pancuronium, vecuronium, and pipecuronium are partially excreted by the kidneys, and their action is prolonged in patients with renal failure. Pancuronkum caused Hypertesion and tachycardia by ‘the combination of vga blockade and catecholaminerelease from adrenergic | nerve endings. Rocuronium (0.9-1.2 mg/kg) has an onset of action that approaches succinylcholine (60-805), making it a suitable alternative for rapid-sequence inductions, but at the cost of a much longer duration of action.10/18/201310/18/2013