Cholinesterase inhibitors, neuromuscular blocking drugs and perioperative memory enhancement.

Inhibition of central nicotinic acetylcholine receptors contributes to secondary effects attributed to anesthesia such as impairment in memory and cognitive performance. the neuromuscular blocking drugs atracurium and the atracurium and cisatracurium metabolite laudanosine, activate nicotinic acetylcholine receptors at concentrations comparable to those measured in the central nervous system during, and for several hours after, general anesthesia. Administration of these neuromuscular blocking drugs, resulting in laudanosine production, has been suggested to improve postoperative cognitive functions, with the clinical relevance that they could have a potentially therapeutic effect in patients with Parkinson’s disease.