ADVERSE-EFFECTS OF DEPOLARIZING NEUROMUSCULAR BLOCKING-AGENTS - INCIDENCE, PREVENTION AND MANAGEMENT

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 acetylch oline, enabling the interaction with receptors at the neuromuscular ju nction. Adverse effects of suxamethonium are generally related to its agonist mode of action. Autonomic cardiovascular effects may result. O ther adverse effects include anaphylactic or anaphylactoid reactions, and histamine release. Various disease states may present specific con siderations in the use of muscle relaxants. Although many complication s of muscle relaxants (such as prolonged block or resistance) are easi ly treated, others may require immediate intervention and vigorous the rapy. Careful selection of appropriate relaxants for particular patien ts will usually prevent the occurrence of complications.