The main clinical use of anticholinesterases is to reverse depolarizing muscle relaxants by indirectly increasing the amount of (acetylcholine) available to compete with the nondepolarizing agent at the motor endplate. Anticholinesterases do this by inhibiting the enzyme acetylcholinesterase which normally breaks down acetylcholine.

Anticholinesterases will prolong the depolarization blockade of succinylcholine.

The anticholinesterases commonly used in anaesthetics today are Neostigmine, Pyridostigmine, Physostigmine and Edrophonium.

see also: general anaesthesia, muscle relaxants