Role of muscle relaxants in pediatric anesthesia

George Meakin, George H. Meakin

    Research output: Contribution to journalArticlepeer-review

    Abstract

    PURPOSE OF REVIEW: Changes in practice and the development of new anesthetic drugs have influenced the use of muscle relaxants in children. This article reviews these developments, and defines the current role and factors affecting the choice of muscle relaxant drugs in pediatric anesthesia. RECENT FINDINGS: The introduction of the laryngeal mask airway as a means of controlling the pediatric airway has reduced the need for muscle relaxants. In cases requiring tracheal intubation, however, a balanced anesthetic technique incorporating a nondepolarizing relaxant provides the best intubating conditions with the minimal potential for adverse effects. The introduction of newer less-toxic, shorter-acting anesthetic drugs has reduced the requirement for muscle relaxants during surgery. Moderate anesthesia with sevoflurane- remifentanil or propofol-remifentanil can keep patients immobile without producing hypotension and facilitate controlled ventilation once the effects of the intubating dose of a muscle relaxant have worn off. SUMMARY: Recent developments in clinical practice have reduced or obviated the need for muscle relaxants in pediatric anesthesia. Muscle relaxants are still indicated for intubation and procedures requiring profound muscle relaxation, and to minimize the amounts of anesthetic drugs given to infants and sick children. Specific relaxants and doses can be chosen to suit the clinical circumstances. © 2007 Lippincott Williams & Wilkins, Inc.
    Original languageEnglish
    Pages (from-to)227-231
    Number of pages4
    JournalCurrent Opinion in Anaesthesiology
    Volume20
    Issue number3
    DOIs
    Publication statusPublished - Jun 2007

    Keywords

    • Atracurium
    • Mivacurium
    • Neuromuscular block
    • Rocuronium
    • Succinylcholine
    • Sugammadex

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