15 May 2026 : Review article
Narrative Review of the Role of Nondepolarizing Neuromuscular Blocking Agents in Anesthesia: Perspective 2026
Paweł Radkowski
ABCDEF 1,2,3, Adam Rafałowicz ABCDEF 4, Urszula Justyna Wojciechowka ABCDEF 5, Marcin Muża DE 6*, Karolina Marczuk E 7, Mateusz Mamala E 7, Łukasz Grabarczyk EFG 8
DOI: 10.12659/MSM.951845
Med Sci Monit 2026; 32:e951845
Table 1 Features of agents described in the article.
| Group | Name | Doses | Features |
|---|---|---|---|
| NMBA | ED ~0.1 mg/kg | Causes a transient hypotensive effect resulting from histamine release. Blocking effect lasts about 10 minutes | |
| ED ~0.042 mg/kg | Fast onset of action, slight hemodynamic effect and a risk of bronochospasm but the block lasts a long time (even to 80 minutes for 75% recovery). Chemical modifications made it less sensitive to L-cysteine | ||
| ED ~0.025 mg/kg | Similar onset of effect but it lasts longer in comparison with gantacurium. Non-depolarazing block lasts 25–40 minutes (95% recovery) | ||
| ED ~0.07 mg/kg | Better hemodynamic stability in comparison with gantacurium (onset and duration are similar). Non-depolarazing block lasts no longer than 10 minutes (95% recovery) | ||
| N/A | Natural toxin, only some pre-clinical studies have been conducted. Non-depolarazing block lasts long (hours) | ||
| RA | 10–50 mg/kg | Irreversibly inactivates fumarate derivatives (gantacurium, CW002, CW011, CW1759-50). Seems to be safe, faster effect than in case of acetylcholinesterase inhibitors | |
| 40–80 mg/kg | Binds both steroid and benzylisoquinoline NMBA. Acts faster than sugammadex. Does not affect cardiovascular system. No recurarisation was observed | ||
| NMBA – neuro-muscular blocking agent; RA – reversal agent. ~ Indicates approximate value. . | |||