Abstract：
Muscle relaxants have broad application in anesthesiology. They can be used for safe intubation, preparing the patient for surgery, or improving mechanical ventilation. Muscle relaxants can be classified based on their mechanism of action into depolarizing and non-depolarizing muscle relaxants and centrally acting muscle relaxants. Non-depolarizing neuromuscular blocking drugs (NMBDs) (eg, tubocurarine, atracurium, pipecuronium, mivacurium, pancuronium, rocuronium, vecuronium) act as competitive antagonists of nicotine receptors. By doing so, these drugs hinder the depolarizing effect of acetylcholine, thereby eliminating the potential stimulation of muscle fibers. Depolarizing drugs like succinylcholine and decamethonium induce an initial activation (depolarization) of the receptor followed by a sustained and steady blockade. These drugs do not act as competitive antagonists; instead, they function as more enduring agonists compared to acetylcholine itself. Many factors can influence the duration of action of these drugs. Among them, electrolyte disturbances and disruptions in acid-base balance can have an impact. Acidosis increases the potency of non-depolarizing muscle relaxants, while alkalosis induces resistance to their effects. In depolarizing drugs, acidosis and alkalosis produce opposite effects. The results of studies on the impact of acid-base balance disturbances on non-depolarizing relaxants have been conflicting. This work is based on the available literature and the authors\' experience. This article aimed to review the use of anesthetic muscle relaxants in patients with acid-base disturbances.
摘要：
肌肉松弛剂在麻醉学中具有广泛的应用。它们可以用于安全插管，为病人准备手术,或改善机械通气。肌肉松弛剂可根据其作用机制分为去极化和非去极化肌肉松弛剂和中枢作用肌肉松弛剂。非去极化神经肌肉阻滞药物（NMBDs）（例如，tubocurarine,阿曲库铵,哌库溴铵,米伐库铵,潘库溴铵,罗库溴铵,维库溴铵）充当尼古丁受体的竞争性拮抗剂。通过这样做,这些药物阻碍了乙酰胆碱的去极化作用，从而消除肌肉纤维的潜在刺激。去极化药物如琥珀酰胆碱和癸甲铵诱导受体的初始激活（去极化），然后持续和稳定的阻断。这些药物不作为竞争性拮抗剂；相反，与乙酰胆碱本身相比，它们的作用更持久。许多因素可以影响这些药物的作用持续时间。其中,电解质干扰和酸碱平衡的破坏可能会产生影响。酸中毒增加非去极化肌肉松弛剂的效力，而碱中毒会诱导对其作用的抵抗。在去极化药物中，酸中毒和碱中毒产生相反的效果。关于酸碱平衡干扰对非去极化松弛剂的影响的研究结果是矛盾的。这项工作是基于现有的文献和作者的经验。本文旨在回顾麻醉肌松药在酸碱紊乱患者中的应用。
