Neuromuscular blockers and reversal drugs

Nondepolarizing neuromuscular blocking agents were introduced into clinical practice more than 60 years ago. Throughout the world, millions of patients receive neuromuscular blocking agents as part of their general anesthetic each year. With use, increased recognition of complications, pharmacologic advances, the ability to monitor depth of neuromuscular blockade, and changes in surgical practice, a better understanding of neuromuscular blockade and its reversal is developing. Because of this, long-acting neuromuscular blocking agents are rarely, if ever, used in the clinical setting; new neuromuscular blocking agents that can be easily reversed and new reversal agents that can reverse even profound neuromuscular blockade are being developed. The goal of this work is to ensure that neuromuscular blockade can be easily, quickly, and reliably reversed and that the safety of providing neuromuscular blockade intraoperatively will increase.