2016
DOI: 10.2147/jpr.s85183
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Neuromuscular blockade in the elderly patient

Abstract: Neuromuscular blockade is a desirable or even essential component of general anesthesia for major surgical operations. As the population continues to age, and more operations are conducted in the elderly, due consideration must be given to neuromuscular blockade in these patients to avoid possible complications. This review considers the pharmacokinetics and pharmacodynamics of neuromuscular blockade that may be altered in the elderly. Compartment distribution, metabolism, and excretion of drugs may vary due t… Show more

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Cited by 19 publications
(13 citation statements)
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References 69 publications
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“…Aging is also associated with decreased muscle blood flow and vascular conductance in the elderly. 12 , 31 Vascular function changes with aging include impaired endothelial function (eg, impaired formation and activation of nitric oxide) and altered reactivity of vascular smooth muscle to sympathetic activity. Age-related structural and functional alterations in the vascular system may explain age-associated reductions in muscle blood flow.…”
Section: Physiologic and Pharmacologic Effects Of Agingmentioning
confidence: 99%
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“…Aging is also associated with decreased muscle blood flow and vascular conductance in the elderly. 12 , 31 Vascular function changes with aging include impaired endothelial function (eg, impaired formation and activation of nitric oxide) and altered reactivity of vascular smooth muscle to sympathetic activity. Age-related structural and functional alterations in the vascular system may explain age-associated reductions in muscle blood flow.…”
Section: Physiologic and Pharmacologic Effects Of Agingmentioning
confidence: 99%
“…Advancing age is associated with increased sensitivity to the central nervous system effects of benzodiazepines; propofol, which requires a 40%–50% lower dose in patients aged >65 years; inhalational anesthetic agents; opioids, especially remifentanil; and local anesthetics. 17 , 32 In the field of NM pharmacology, possible changes in receptor biological features (eg, ligand affinity and kinetics), perhaps occurring simultaneously with altered blood flow to muscles, 12 , 17 has been suggested to occur in elderly patients. 33 , 34 These changes involve slower release of NMBAs from receptors, delayed recovery of receptors, and possibly altered receptor expression at the NM junction.…”
Section: Pharmacology In the Elderlymentioning
confidence: 99%
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