Neuromuscular blocking drugs in continuous infusion in total intravenous general anesthesia

Abstract

Introduction: The administration of anesthetic agents intravenously started a new modality that involved the administration of anesthetics in the form of continuous infusions.
Objective: To update the information on the function of neuromuscular blocking drugs when administered in continuous infusion in total intravenous general anesthesia.
Development: Neuromuscular blocking drugs can be administered in continuous infusion to maintain a stable plasma concentration and achieve adequate relaxation of the patient during the surgical procedure, as well as a faster and safer spontaneous recovery, based on the action onset of the drug used, but fundamentally on its maximum effect. Despite this, it is important to administer an initial loading dose that must range from 2 to 3 DE 95 (effective dose to decrease the response to the stimulus in 95% of its initial value) and continue with the administration in continuous infusion as part of the maintenance of anesthesia.
Conclusions: Regardless the different criteria among authors, most agree that continuous infusions are effective in maintaining greater blood stability and, therefore, lower doses of neuromuscular blocking drugs, shorter real reversal times and fewer adverse effects.