Selective reversal of muscle relaxation in general anesthesia: focus on sugammadex.

摘要: Despite the significant improvements in pharmacology of muscle relaxants past six decades, search for ideal relaxant continues, mainly because incomplete efficacy and persistent side effects associated with their antagonism. Clinical concerns remain about residual paralysis hemodynamic classic pharmacologic reversal agents, acetylcholinesterase inhibitors. Although development "ideal relaxant" remains illusory, advancements hold promise improved clinical care patient safety. Recent advances include short-acting nondepolarizing agents that have fast onset a very rapid metabolism allows reliable complete recovery; selective, "designer" are specific single drug or class drugs. This article reviews recent developments these selective agents: plasma cholinesterases, cysteine, sugammadex. each is its substrate, use combination agent will allow much greater intraoperative titrating ability, decreased effect profile, may result incidence postoperative