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中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2022, Vol. 18 ›› Issue (03): 262 -268. doi: 10.3877/cma.j.issn.1673-5250.2022.03.003

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Effects of muscle relaxation antagonists and muscle relaxation monitoring in pediatric clinical anesthesia

Hongyang Chen1, Lei Yang1, Zining Wang2, Di Yang3, Yixuan Wu1, Yunxia Zuo1,†()   

  1. 1Department of Anesthesiology, West China Hospital of Sichuan University, Innovation Unit of Perioperative Stress Risk Assessment and Clinical Decision of Chinese Academy of Medical Sciences (2018RU012), Chengdu 610041, Sichuan Province, China
    2West China School of Clinical Medicine of Sichuan University, Chengdu 610041, Sichuan Province, China
    3Department of Anesthesiology, Sichuan Provincial People′s Hospital, Chengdu 610015, Sichuan Province, China
  • Received:2021-08-04 Revised:2022-05-04 Published:2022-06-01
  • Corresponding author: Yunxia Zuo
  • Supported by:
    National Key Research and Development Program of China(2020YFC2005303); Discipline Excellent Development 1.3.5 Project of West China Hospital, Sichuan University (Anesthesia Discipline Excellent Development Project)(ZY2016101)
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Muscle relaxant antagonists (MRA) are antagonists of skeletal muscle relaxants (SMR), which are mainly divided into anticholinesterase agents, such as neostigmine and pyridostigmine, K+ channel blockers and specific antagonists of amino-steroid non-depolarizing SMR (sugammadex). Muscle relaxation monitoring refers to continuous monitoring of degree of muscle relaxation, which can objectively reflecting growth and decline process of effect of SMR. With widespread use of SMR in clinical practice, effects of residual blockade of muscle relaxants (RBMR) have attracted more and more attention from anesthesiologists. RBMR may lead to delayed recovery from anesthesia, hypopnea, hypoxia, asphyxia, and even death in children during anesthesia recovery. Combined use of MRA and muscle relaxation monitoring during perioperative period can effectively prevent occurrence of postoperative RBMR in children during anesthesia recovery. Considering poor tolerance of hypoxia in children, RBMR is more harmful to children during anesthesia recovery and may lead to more adverse reactions than those to adults. Therefore, how to reduce the incidence of adverse reactions of postoperative RBMR to children during anesthesia recovery is one of the important issues that anesthesiologists need to pay attention to and solve. The author intends to describe pharmacological characteristics of MRA and the latest research progress in application of intraoperative muscle relaxation monitoring in pediatric anesthesia.

Key words: Neuromuscular blocking agents, Muscle relaxation, Neostigmine, Muscle relaxation monitoring, Anesthesia recovery period, Narcotic antagonists, Delayed emergence from anesthesia, Child
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