Conventional theories of neuromuscular block often fail to explain many everyday clinical observations. Scientific progress depends upon questioning the cause of these paradoxes and proposing alternative explanations. Research tests these hypotheses and allows us to seek a preferred explanation of these events. Drawing heavily on his own research experiences over some 35 years, the author has set out to present alternative explanations of everyday experiences in the use of neuromuscular blocking agents in a manner readily understandable to clinical anaesthetists. This is not meant to be a definitive textbook on muscle relaxants. Rather, this book emphasises what is NOT known and which information (presented as fact) leaves questions unanswered. Much of the book is new information and many of the explanations offered are original; some are controversial. If Neuromuscular Block provokes discussion and causes a measurement of established theories, it will have served its purpose.
Preface; Introduction; History; The Neuromuscular junction; Neuromuscular transmission; Acetylcholine: formation and metabolism; Neuromuscular block (non depolarizing); Isolated arm experiments; Explanations of clinical events based on biophase binding; Pharmacokinetics and pharmacokinetic models; Onset of action of non-depolarizing drugs; Presynaptic nicotinic receptors; Reversing the action of non-depolarizing drugs; Sensitivity to a second dose of drug; The priming principle; Depolarizing neuromuscular block; Hypothermia and neuromuscular block; Monitoring neuromuscular conduction; Ideal muscle relaxant; The muscle relaxant drugs; Index
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