A clinically orientated monograph covering the mechanism of neuromuscular block, its reversal and the clinical importance of the various factors that affect it. The aim is to make basic science understandable to the practising anaesthetist.
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The neuromuscular junction
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AChR activity administered affinity agonist Anaesth Anaesthesia Anesthesiology anticholinesterase atracurium biophase binding sites block produced blood flow bolus Bowman WC cause choline cholinesterase clinical concentration gradient concentration of drug curare decamethonium demonstrated depolarizing drugs depression dose of drug dose of vecuronium ED95 dose edrophonium effect end-plate evidence excretion explain Feldman gallamine Hood JR hypothermia increase injection intubation isolated forearm mechanism metabolism mivacurium molecules muscle relaxants muscular block neostigmine neuro neuromuscular blocking drugs neuromuscular conduction neuromuscular junction neuromuscular transmission non-depolarizing block non-depolarizing drugs observed occurs onset and offset onset of block pancuronium patients pharmacokinetic Pharmacol phrenic nerve phrenic nerve diaphragm Physiol plasma plasma concentration plasma level postsynaptic membrane presynaptic priming prolonged rapid onset rate of onset rate of stimulation receptor occupancy reduced residual result reversal rocuronium subunits suggested suxamethonium synaptic cleft temperature tetanic fade TOF fade tourniquet tubocurare tubocurarine twitch response vecuronium vesicles Waud whilst Zaimis