Reversal Agents for Neuromuscular Blocking Drugs

Reversal agents for neuromuscular blocking drugs are therapeutic medications administered to counteract muscle paralysis induced by nondepolarizing neuromuscular blocking agents during anesthesia.

This functional class operates primarily through two distinct mechanisms: acetylcholinesterase inhibitors, such as neostigmine, which increase acetylcholine concentrations at the neuromuscular junction to outcompete the blocking agent, and selective binding relaxant encapsulation agents, such as sugammadex, which chelate and encapsulate circulating aminosteroid neuromuscular blockers.

These agents are primarily used in perioperative and critical care medicine to accelerate motor and respiratory recovery, facilitate safe tracheal extubation, and prevent postoperative residual curarization and associated pulmonary complications.