Transcript of Bloqueantes neuromusculares de producir parálisis muscular actuando en la unión neuromuscular, BNM no despolarizantes. Transcript of Bloqueantes Neuromusculares Antagonismo del Bloqueo Neuromuscular No despolarizantes (Antagonistas- Competitivos). Relajantes neuromusculares Especial interés tiene el manejo de la [58] y una respuesta a los fármacos bloqueantes neuromusculares [59] similar a la de los y resistencia a la acción de los relajantes musculares no despolarizantes.

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Avoidance versus use of neuromuscular blocking agents for improving conditions during tracheal intubation or direct laryngoscopy in adults and adolescents. Cochrane Database Syst Rev ; 5: CD, May Tracheal intubation during induction of bloqieantes anaesthesia is a vital procedure performed to secure a patient’s airway. Several studies have identified difficult tracheal intubation DTI or failed tracheal intubation as one of the major contributors to anaesthesia-related mortality and morbidity.

Use of neuromuscular blocking agents NMBA to facilitate tracheal intubation is a widely accepted practice. However, because of adverse effects, NMBA may be undesirable.


Cohort studies have indicated that avoiding NMBA is an independent risk factor for difficult and failed tracheal intubation. However, neuromuscculares systematic review of randomized trials has evaluated conditions for tracheal intubation, possible adverse effects, and postoperative discomfort.

To evaluate the boqueantes of avoiding neuromuscular blocking agents NMBA versus using NMBA on difficult tracheal intubation DTI for adults and adolescents allocated to tracheal intubation with direct laryngoscopy. To look at various outcomes, conduct subgroup and sensitivity analyses, examine the role of bias, and apply trial sequential analysis TSA to examine the level of available evidence for this intervention.

Current Controlled Trials; ClinicalTrials. We checked the reference lists of included trials and reviews to look for unidentified trials.

We included randomized controlled trials RCTs that compared the effects of avoiding versus using NMBA in participants 14 years of age or older. Two review authors extracted data independently.

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We used published data and data obtained by contacting trial authors. To minimize the risk of systematic error, we assessed the risk of bias of included trials.


To reduce the risk of random errors caused by sparse data and repetitive updating of cumulative meta-analyses, we applied TSA. We identified 34 RCTs with participants that met our inclusion criteria. All trials reported on conditions for tracheal intubation; seven trials with participants described ‘events of upper airway discomfort or injury’, and 13 trials with participants reported on direct laryngoscopy.

All trials used neuromksculares parallel design.

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We identified 18 dose-finding studies that included more interventions or control groups or both. All trials except three included only American Society of Anesthesiologists ASA class I and II participants, 25 trials excluded participants with anticipated DTI, and obesity or overweight was an excluding factor in 13 studies.

Eighteen trials used suxamethonium, and 18 trials used non-depolarizing NMBA.