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Adverse Effects of Depolarising Neuromuscular Blocking Agents

Incidence, Prevention and Management

  • Review Article
  • Drug Experience
  • Published:
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Summary

Muscle relaxants block neuromuscular transmission, acting at nicotinic acetylcholine receptors of the neuromuscular junction. Suxamethonium (succinylcholine) is a depolarising agent, whereas all other relaxants in clinical use are nondepolarising. The desired neuromuscular block results from the structural similarity of muscle relaxants to acetylcholine, enabling the interaction with receptors at the neuromuscular junction. Adverse effects of suxamethonium are generally related to its agonist mode of action. Autonomic cardiovascular effects may result. Other adverse effects include anaphylactic or anaphylactoid reactions, and histamine release. Various disease states may present specific considerations in the use of muscle relaxants. Although many complications of muscle relaxants (such as prolonged block or resistance) are easily treated, others may require immediate intervention and vigorous therapy. Careful selection of appropriate relaxants for particular patients will usually prevent the occurrence of complications.

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  1. Department of Anesthesiology, The Mount Sinai Medical Center, Box 1010, One Gustave L. Levy Place, New York, New York, 10029, USA

    W. Jeffrey Book, Mark Abel & James B. Eisenkraft

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  1. W. Jeffrey Book
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  2. Mark Abel
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  3. James B. Eisenkraft
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Book, W.J., Abel, M. & Eisenkraft, J.B. Adverse Effects of Depolarising Neuromuscular Blocking Agents. Drug-Safety 10, 331–349 (1994). https://doi.org/10.2165/00002018-199410050-00001

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