Neuromuscular blocking drugs and their antagonists in patients with organ disease

Anaesthesia. 2009 Mar:64 Suppl 1:55-65. doi: 10.1111/j.1365-2044.2008.05871.x.


The pharmacodynamics and pharmacokinetics of the currently available neuromuscular blocking and reversal drugs may be altered by organ disease. Adverse effects such as prolonged neuromuscular block, postoperative residual curarisation, recurarisation, the muscarinic effects of the anticholinesterases, and the side-effects of the antimuscarinics are encountered more frequently. This review will consider these potential problems and assess the role of sugammadex in enabling the anaesthetist to avoid them. It will also present the latest knowledge regarding the safety and efficacy of sugammadex in patients with renal, hepatic, cardiovascular and pulmonary disease.

Publication types

  • Review

MeSH terms

  • Anesthesia Recovery Period
  • Humans
  • Kidney Failure, Chronic / physiopathology*
  • Liver Diseases / physiopathology*
  • Neuromuscular Blockade / methods
  • Neuromuscular Blocking Agents / antagonists & inhibitors
  • Neuromuscular Blocking Agents / pharmacology*
  • Neuromuscular Junction / drug effects
  • Neuromuscular Junction / physiopathology
  • Sugammadex
  • gamma-Cyclodextrins / pharmacology


  • Neuromuscular Blocking Agents
  • gamma-Cyclodextrins
  • Sugammadex