29 May 2024 : Review article
[In Press] The Influence of Acid-Base Balance on Anesthetic Muscle Relaxants: A Comprehensive Review on Clinical Applications and Mechanisms
Paweł Radkowski![ORCID logo](https://jours.isi-science.com/images/id_icon_32.png)
![ORCID logo](https://jours.isi-science.com/images/id_icon_32.png)
![ORCID logo](https://jours.isi-science.com/images/id_icon_32.png)
![ORCID logo](https://jours.isi-science.com/images/id_icon_32.png)
![ORCID logo](https://jours.isi-science.com/images/id_icon_32.png)
DOI: 10.12659/MSM.944510
Med Sci Monit In Press; DOI: 10.12659/MSM.944510
Available online: 2024-05-29, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
Abstract
ABSTRACT
Muscle relaxants have broad application in anesthesiology. They can be used for safe intubation, preparing the patient for surgery, or improving mechanical ventilation. Muscle relaxants can be classified based on their mechanism of action into depolarizing and non-depolarizing muscle relaxants and centrally acting muscle relaxants. Non-depolarizing neuromuscular blocking drugs (NMBDs) (eg, tubocurarine, atracurium, pipecuronium, mivacurium, pancuronium, rocuronium, vecuronium) act as competitive antagonists of nicotine receptors. By doing so, these drugs hinder the depolarizing effect of acetylcholine, thereby eliminating the potential stimulation of muscle fibers. Depolarizing drugs like succinylcholine and decamethonium induce an initial activation (depolarization) of the receptor followed by a sustained and steady blockade. These drugs do not act as competitive antagonists; instead, they function as more enduring agonists compared to acetylcholine itself. Many factors can influence the duration of action of these drugs. Among them, electrolyte disturbances and disruptions in acid-base balance can have an impact. Acidosis increases the potency of non-depolarizing muscle relaxants, while alkalosis induces resistance to their effects. In depolarizing drugs, acidosis and alkalosis produce opposite effects. The results of studies on the impact of acid-base balance disturbances on non-depolarizing relaxants have been conflicting. This work is based on the available literature and the authors’ experience. This article aimed to review the use of anesthetic muscle relaxants in patients with acid-base disturbances.
Keywords: Acid-Base Imbalance; Acidosis; Alkalosis; Neuromuscular Blocking Agents; Review
Editorial
01 June 2024 : Editorial
Editorial: Concerns as Highly Pathogenic Avian Influenza (HPAI) Virus of the H5N1 Subtype is Identified in Dairy Cows and Other MammalsDOI: 10.12659/MSM.945315
Med Sci Monit 2024; 30:e945315
In Press
Clinical Research
Effect of COVID-19 on Thrombosis Incidence and Patient Prognosis in Kidney Transplant RecipientsMed Sci Monit In Press; DOI: 10.12659/MSM.944285
Review article
The Influence of Acid-Base Balance on Anesthetic Muscle Relaxants: A Comprehensive Review on Clinical Appli...Med Sci Monit In Press; DOI: 10.12659/MSM.944510
Clinical Research
Enhancement of Pulmonary Function and Reduction of Complications Through EIT-Guided Yoga Breathing Exercis...Med Sci Monit In Press; DOI: 10.12659/MSM.942954
Clinical Research
Physical Factors Associated with Non-Specific Neck Pain: Correlations Among Pain, Disability, Posture, Endu...Med Sci Monit In Press; DOI: 10.12659/MSM.944614
Most Viewed Current Articles
17 Jan 2024 : Review article 2,541,852
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research 1,562,020
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research 690,605
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial 50,475
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952