The future of neuromuscular blocking agents.
Journal
Current opinion in anaesthesiology
ISSN: 1473-6500
Titre abrégé: Curr Opin Anaesthesiol
Pays: United States
ID NLM: 8813436
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
entrez:
7
7
2020
pubmed:
7
7
2020
medline:
9
7
2020
Statut:
ppublish
Résumé
The present review provides a summary of the literature on recent development of new neuromuscular blocking agents and presents clinically well established and new reversal agents. Anesthesiologists are still waiting for the ideal neuromuscular blocking agent with a succinylcholine-like rapid onset and offset without side effects. Recent drug development led to a new series of neuromuscular compounds, called the chlorofumarates such as gantacurium, CW002, and CW011. These drugs have a promising pharmacodynamic profile; importantly, they can rapidly be reversed by L-cysteine adduction without relevant side effects. In addition, a new spectrum of reversal agents are currently examined in preclinical studies: adamgammadex sodium, a modified γ-cyclodextrin derivate that forms an inactive tight inclusion complex with rocuronium or vecuronium and calabadions, capable of reversing both benzylisoquinolines and steroidal neuromuscular blocking agents. Although the recent advancements in neuromuscular research are very promising, to date, the presented drugs are currently not available for clinical use. Clinical studies will determine the role of these developments in anesthesia practice. Therefore, well established combinations such as rocuronium-sugammadex are popular in clinical practice to offer quick paralysis for intubation and to optimize surgical conditions, while providing a fast neuromuscular recovery at the end of surgery.
Identifiants
pubmed: 32628397
doi: 10.1097/ACO.0000000000000891
pii: 00001503-202008000-00004
doi:
Substances chimiques
CW 002
0
CW 011
0
Isoquinolines
0
Maleates
0
Neuromuscular Blocking Agents
0
Neuromuscular Nondepolarizing Agents
0
Sugammadex
361LPM2T56
gantacurium
N9VK9ZO25E
Rocuronium
WRE554RFEZ
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
490-498Références
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