Neuromuscular Blocking Drugs in Infants and Children

Skeletal muscle relaxation can be produced by deep inhalational anesthesia, regional nerve block, or neuromuscular blocking agents (commonly called muscle relaxants). In 1942, Harold Griffith published the results of a study using a refined extract of curare (a South American arrow poison) during anesthesia. Muscle relaxants rapidly became a routine part of the anesthesiologist’s drug arsenal. As Griffith noted, it is important to realize that neuromuscular junction blocking agents produce paralysis, not anesthesia. In other words, muscle relaxation does not ensure unconsciousness, amnesia, or analgesia (Morgan 2006).Since the introduction of the neuro-muscular blocking agents (NMBAs) in 1942, a marked evolution has occurred in these drugs, with progressive increase in their potency combined with fewer risks or adverse effects