Therapeutic Uses

Neuromuscular blocking agents are used mainly as adjuvants in surgical anesthesia to relax skeletal muscle, particularly of the abdominal wall, to facilitate operative manipulations; with muscle relaxation not dependent on the depth of general anesthesia, a much lighter level of anesthesia suffices, minimizing risk of respiratory and cardiovascular depression and shortening postanesthetic recovery. Neuromuscular blocking agents will not substitute for inadequate depth of anesthesia.

Muscle relaxation is useful in orthopedic procedures (e.g., correction of dislocations, alignment of fractures). Neuromuscular blocking agents of short duration often are used to facilitate endotra-cheal intubation and have been used to facilitate laryngoscopy, bronchoscopy, and esophagoscopy in combination with a general anesthetic agent.

Neuromuscular blocking agents are administered parenterally, generally intravenously. These drugs are hazardous and should be administered to patients only by clinicians who have had extensive training in their use and in a setting where facilities for respiratory and cardiovascular resuscitation are immediately at hand.

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