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Vol. 40. Núm. 2.
Páginas 127-130 (Mayo - Julio 2012)
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Vol. 40. Núm. 2.
Páginas 127-130 (Mayo - Julio 2012)
DOI: 10.1016/S2256-2087(12)70026-3
Acceso a texto completo
Strategies to Reduce the Most Frequent Adverse Events of Neuromuscular Blocking Agents
Estrategias para disminuir los eventos adversos más frecuentes relacionados con bloqueadores neuromusculares
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Fredy Ariza Cadena??
Autor para correspondencia
fredyariza@hotmail.com

Corresponding author: Fundación Valle del Lili, Avda. Simón Bolívar, Cra 98 # 18-49, Cali, Colombia.
Transplant anesthesiologist and epidemiologist, Fundación Valle de Lili, Cali, Colombia
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Abstract

Neuromuscular blocking agents are without doubt the drugs most frequently associated with perioperative adverse events in anesthesia. Acknowledging and treating those patients at high risk of developing unexpected events caused by the administration of these agents should become a routine for the perioperative medicine specialist. This article is a reflection on simple pharmacokinetics and pharmacodynamics for improved safety in the administration of NMBs by the anesthesiologist. Preserving internal homeostasis, thermoprotection and securing microcirculation are key strategies for reducing events such as postoperative residual curarization. Furthermore, a right clinical approach to patients at high risk of developing NMBrelated hypersensitivity reactions enables a safe and comprehensive management of the patient, avoiding subsequent and more severe or even fatal events.

Keywords:
Neuromuscular blocking agents
Pharmacokinetics
Neuromuscular blockade
Ambulatory surgical procedures
Resumen

Los bloqueadores neuromusculares (BNM) son, sin duda, los medicamentos más asociados a eventos adversos perioperatorios con que debe lidiar el anestesiólogo. Reconocer y tratar a los pacientes con alto riesgo de eventos inesperados relacionados con la aplicación de estos medicamentos debe convertirse en una rutina para el especialista en medicina perioperatoria. Este artículo de reflexión plantea sencillos conceptos de farmacocinética y farmacodinámica que permiten al anestesiólogo hacer más segura la administración de BNM. La preservación de la homeostasis interna, la termoprotección y asegurar la microcirculación son estrategias básicas para disminuir eventos como la curarización residual postoperatoria. Por otra parte, un adecuado enfoque clínico para pacientes en riesgo de reacciones de hipersensibilidad a BNM permite brindarles un manejo seguro e integral, previniendo posteriores eventos de mayor severidad o incluso fatales.

Palabras clave:
Bloqueadores neuromusculares
Farmacocinética
Bloqueo neuromuscular
Procedimientos quirúrgicos
ambulatorios
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Copyright © 2012. Sociedad Colombiana de Anestesiología y Reanimación
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