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Rocuronium

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https://www.readbyqxmd.com/read/28320323/changes-in-duration-of-action-of-rocuronium-following-decrease-in-hepatic-blood-flow-during-pneumoperitoneum-for-laparoscopic-gynaecological-surgery
#1
Yang Liu, Wen Cao, Yu Liu, Yun Wang, Ren Lang, Yun Yue, An-Shi Wu
BACKGROUND: A moderate insufflation pressure and deep neuromuscular blockade (NMB) have been recommended in laparoscopic surgery in consideration of the possible reduction in splanchnic perfusion due to the CO2-pneumoperitoneum. Since the liver is the major organ for rocuronium metabolism, the question of whether NMB of rocuronium would change with the variation of liver perfusion during pneumoperitoneum during laparoscopic surgery merits investigation. METHODS: In this prospective study, a total of sixty female patients scheduled for either selective laparoscopic gynaecological surgery (group laparoscopy) or laparotomy for gynaecological surgery (group control) were analyzed...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28294589/selective-hypersensitivity-to-cefazolin-and-contribution-of-the-basophil-activation-test
#2
J P Almeida, A Lopes, A Campos Melo, M C Pereira Santos, M Pereira Barbosa
The authors present 2 case reports of selective cefazolin hypersensitivity: a 49 year-old woman with a history of two perioperative reactions (urticaria and severe anaphylaxis) after the use of rocuronium, propophol and cefazolin; a 36 year-old pregnant woman who developed facial erythema, lips angioedema and hypotension immediately after administration of ropivacain, sufentanil, cefazolin, oxytocin and ephedrine. In both cases, intradermal skin tests were positive for cefazolin. A basophil activation test was performed for cefazolin, which was positive in one patient...
March 2017: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28289767/-update-on-muscle-relaxation-what-comes-after-succinylcholine-rocuronium-and-sugammadex
#3
N Zoremba, G Schälte, C Bruells, F K Pühringer
Due to the great advantages, it is not possible to imagine current practice in anesthesia without the adminstration of muscle relaxants. For a long time the administration of succinylcholine for rapid sequence induction (RSI) was considered to be the state of the art for patients at risk for aspiration. The favorable characteristics are, however, accompanied by many, sometimes severe side effects. Due to the development of non-depolarizing muscle relaxants, in particular rocuronium in combination with sugammadex, there is the possibility to achieve a profile of action similar to succinylcholine with low side effects...
March 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28288573/hemoglobin-vesicles-prolong-the-time-to-circulatory-collapse-in-rats-during-apnea
#4
Yusuke Naito, Hiromi Sakai, Satoki Inoue, Masahiko Kawaguchi
BACKGROUND: Hemoglobin vesicles (HbV) are hemoglobin-based oxygen carriers manufactured by liposome encapsulation of hemoglobin molecules. We hypothesised that the infusion of oxygenated HbV could prolong the time to circulatory collapse during apnea in rats. METHODS: Twenty-four Sprague-Dawley rats were randomly divided into four groups (Air, Oxy, NS and HbV). The rats were anaesthetized with isoflurane and the trachea was intubated using 14-gauge intravenous catheters...
March 14, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28265685/laparoscopic-partial-nephrectomy-in-a-patient-on-simvastatin-delayed-recovery-from-neuromuscular-blockade
#5
E E Abd El-Hakeem, A M Kaki, S A Almazlom, A J Alsayyad
Delayed recovery from anesthesia remains a very challenging subject for anesthesiologists. This case report describes the clinical course of delayed recovery from neuromuscular blockade after laparoscopic partial nephrectomy in a patient on simvastatin. The patient was hypertensive on regular treatment with oral captopril 25 mg twice daily and amlodipine 5 mg once daily and hypercholesterolemic on regular simvastatin 40 mg once daily with a normal electrocardiogram (ECG). All preoperative laboratory findings were within normal ranges...
March 6, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28261559/effects-of-combined-rocuronium-and-cisatracurium-in-laparoscopic-cholecystectomy
#6
Woo Young Park, Kwang Ho Lee, Young Bok Lee, Myeong Hoon Kim, Hyun Kyo Lim, Jong Bum Choi
BACKGROUND: Laparoscopic upper abdominal surgery can cause spontaneous respiration due to diaphragmatic stimulation and intra-abdominal CO2 inflation. Therefore, sufficient muscle relaxation is necessary for a safe surgical environment. METHODS: We investigated if the combination of rocuronium and cisatracurium can counteract the delayed onset of cisatracurium's action and delayed recovery of muscle relaxation and whether the dosage of rocuronium, which is metabolized hepatically, can be reduced...
January 2017: Journal of Lifestyle Medicine
https://www.readbyqxmd.com/read/28258478/in-vitro-diagnosis-of-immediate-drug-hypersensitivity-anno-2017-potentials-and-limitations
#7
REVIEW
I I Decuyper, E A Mangodt, A L Van Gasse, K Claesen, A Uyttebroek, M Faber, V Sabato, C H Bridts, C Mertens, M M Hagendorens, L S De Clerck, Didier G Ebo
BACKGROUND: For most physicians, quantification of drug-specific immunoglobulin E (drug-sIgE) antibodies constitutes the primary in vitro measure to document immediate drug hypersensitivity reactions (IDHR). Unfortunately, this is often insufficient to correctly identify patients with IgE-mediated IDHR and impossible for non-IgE-mediated IDHR that result from alternative routes of basophil and mast cell activation. In these difficult cases, diagnosis might benefit from cellular tests such as basophil activation tests (BAT)...
March 4, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28256329/-functional-residual-capacity-increase-during-laparoscopic-surgery-with-abdominal-wall-lift
#8
Hiroshi Ueda, Takuo Hoshi
BACKGROUND AND OBJECTIVES: The number of laparoscopic surgeries performed is increasing every year and in most cases the pneumoperitoneum method is used. One alternative is the abdominal wall lifting method and this study was undertaken to evaluate changes of functional residual capacity during the abdominal wall lift procedure. METHODS: From January to April 2013, 20 patients underwent laparoscopic cholecystectomy at a single institution. All patients were anesthetized using propofol, remifentanil and rocuronium...
February 27, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28238585/recovery-from-rocuronium-induced-neuromuscular-block-was-longer-in-the-larynx-than-in-the-pelvic-limb-of-anesthetized-dogs
#9
Daniel M Sakai, Manuel Martin-Flores, Marta Romano, Chia T Tseng, Luis Campoy, Robin D Gleed, Jonathan Cheetham
OBJECTIVE: To determine if neuromuscular monitoring at the pelvic limb accurately reflects neuromuscular function in the larynx after administration of rocuronium in anesthetized dogs. STUDY DESIGN: Prospective experimental study. ANIMALS: Six healthy Beagle dogs. METHODS: Anesthesia was maintained in dogs with isoflurane and a continuous infusion of dexmedetomidine. Rocuronium (0.6 mg kg(-1)) was administered intravenously to induce neuromuscular block...
January 7, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28236874/successful-use-of-sugammadex-for-caesarean-section-in-a-patient-with-myasthenia-gravis
#10
Lokman Soyoral, Ugur Goktas, Muhammed Bilal Cegin, Volkan Baydi
Myasthenia gravis is an autoimmune disorder that is characterized by muscle weakness that fluctuates, worsening with exertion, and improving with rest. Diagnosis of myasthenia gravis is made following clinical and physical examination and is confirmed by serum immunoassays to measure autoantibody levels. Myasthenia gravis especially when associated with pregnancy is a high-risk disease, and its course is unpredictable. We described the second report about use of sugammadex after rocuronium for a caesarean delivery with myasthenia gravis, but, unlike our case that formerly was diagnosed with myasthenia gravis, the patient was extubated on postoperative successfully and we did not encounter any respiratory problems...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28235523/fast-track-anesthesia-in-patients-undergoing-outpatient-laparoscopic-cholecystectomy-comparison-of-sevoflurane-with-total-intravenous-anesthesia
#11
Ceyda Özhan Çaparlar, Mehmet Özgür Özhan, Mehmet Anıl Süzer, Dilek Yazicioğlu, Mehmet Burak Eşkin, Serkan Şenkal, Mehmet Ali Çaparlar, Ersin Özkan Imren, Bülent Atik, Nedim Çekmen
BACKGROUND: The use of short-acting anesthetics has introduced a "fast-track anesthesia" concept in outpatient surgery which provides discharge of the patients from operation room directly to the phase II recovery area without entering into postanesthesia care unit. The aim of this prospective and randomized study was to compare general anesthesia using sevoflurane with propofol-remifentanil-based total intravenous anesthesia (TIVA) for fast-track eligibility in patients undergoing outpatient laparoscopic cholecystectomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235515/case-report-neuromuscular-block-induced-by-rocuronium-following-sugammadex-administration
#12
Tugba Askin, Suheyla Unver, Deniz Oguz, Kubra Kutay
We present a case in which rocuronium was applied for muscle relaxation following the administration of sugammadex. An emergency surgery under general anesthesia was planned for a 43-year-old male patient due to an L1 vertebral corpus and right tibia-fibula shaft fracture. Anesthesia was induced with fentanyl, propofol and lidocaine. After applying only 30mg of the total induction dose of rocuronium, it was learned that the neurological examination should be controlled again from the surgeon because of the controversial of the neurological deficit...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235514/atypical-presentation-to-rocuronium-allergy-in-a-19-year-old-female-patient
#13
Vladimir Kuric, Khaled J Zaza, Sulaiman S Algazlan
The danger of anaphylaxis, a rare but life threatening complication of general anesthesia (GA) can be summarized in two: 1. General Anesthesia masks the typical early signs of allergy which can be seen in an awake patient. 2. Anaphylaxis during GA manifests mostly as circulatory/ventilatory failures which can be interpreted as adverse effects of anesthetics or surgery and this can lead to critical delay of effective therapy. A 19-year-old female admitted for posterior spinal fusion and instrumentation (the 5th surgery in patient's life) desaturated seconds after intubation...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235495/use-of-sugammadex-in-an-octagenerian-with-myaesthenia-gravis-undergoing-emergency-laporotomy
#14
Deep Shah, Aynkaran Dharmarajah
BACKGROUND: Myaesthenia Gravis is an autoimmune disorder that results in increased sensitivity to neuromuscular blockers. Anaesthesia and surgery in patients with Myaesthenia Gravis is associated with an increased incidence of complications, including post operative ventilation. We report the successful use of intra-operative train of four ratio monitoring and Sugammadex to reverse rocuronium induced neuromuscular blockade in an elderly octagenarian with Myaesthenia Gravis undergoing an emergency laporotomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28222701/the-effect-of-deep-muscle-relaxation-on-the-force-required-during-latissimus-dorsi-dissection-for-breast-reconstructive-surgery-results-of-a-prospective-double-blinded-observational-pilot-study
#15
T Ledowski, A Goodwin-Walters, P Quinn, M Calvert
BACKGROUND: The use of neuromuscular blocking agents has previously been suggested to facilitate the dissection of the latissimus dorsi muscle during breast reconstructive surgery. The aim of this study was to quantify the influence of deep muscle relaxation on the force required to lift the latissimus dorsi muscle during flap preparation. METHODS: After ethics approval and written informed consent 15 patients scheduled for elective breast reconstruction with a latissimus dorsi pedicled flap (muscle flap, not myocutaneous flap) under general anaesthesia were prospectively included...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28219129/-effects-of-sevoflurane-and-desflurane-on-pharmacodynamics-of-rocuronium-in-children
#16
D X Kang, Y Q Rao, B Ji, J Li
Objective: To observe the intraoperative influences on pharmacodynamics of rocuronium in children inhaling sevoflurane and desflurane for 40 min balance. Methods: Ninety children (ASAⅠ-Ⅱ) undergoing elective surgery with general anesthesia in Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University from July 2015 to May 2016 were randomly assigned into six groups (n=15): Sevoflurane group (group S1 and S2), Desflurane group (group D1 and D2) and Propofol group (group P1 and P2)...
February 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28207549/stylet-angulation-for-routine-endotracheal-intubation-with-mcgrath-videolaryngoscope
#17
RANDOMIZED CONTROLLED TRIAL
Jiyoung Lee, Jong Yeop Kim, Se Yoon Kang, Hyun Jeong Kwak, Dongchul Lee, Sook Young Lee
BACKGROUND: The McGrath videolaryngoscope (VL) provides excellent laryngoscopic views, but directing an endotracheal tube can be difficult, and thus the routine use of a stylet is recommended. The goal of this study is to determine the appropriate angle (60° vs 90°) of the stylet when using the McGrath VL by comparing the time to intubation (TTI). METHODS: One hundred and forty patients aged 19 to 70 years (American Society of Anesthesiologists classification I or II) who required tracheal intubation for elective surgery were randomly allocated to 1 of 2 groups, at the 60° angle (n = 70) or the 90° angle (n = 70)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205213/haemodynamic-changes-to-a-midazolam-fentanyl-rocuronium-protocol-for-pre-hospital-anaesthesia-following-return-of-spontaneous-circulation-after-cardiac-arrest
#18
M Miller, C Groombridge, R Lyon
Following the return of spontaneous circulation after out-of-hospital cardiac arrest, neurological dysfunction, airway or ventilatory compromise can impede transport to early percutaneous coronary intervention, necessitating pre-hospital or emergency department anaesthesia to facilitate this procedure. There are no published reports of the ideal induction agents in these patients. We sought to describe haemodynamic changes associated with induction of anaesthesia using a midazolam (0.1 mg.kg(-1) ), fentanyl (2 μg...
February 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28185260/a-comparison-of-sugammadex-and-neostigmine-for-reversal-of-rocuronium-induced-neuromuscular-blockade-in-children
#19
RANDOMIZED CONTROLLED TRIAL
A S Ammar, K M Mahmoud, Z A Kasemy
BACKGROUND: Sugammadex is designed to be a reversal agent for steroidal muscle relaxants. The current trial was aimed to compare between sugammadex and neostigmine concerning the recovery time from neuromuscular blockade. We hypothesised that sugammadex might have shorter recovery time than neostigmine. METHODS: Sixty paediatric patients aged 2-10 years scheduled for lower abdominal surgeries were randomly assigned into two equal groups to receive 4 mg/kg sugammadex (Group S) or 0...
April 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28184275/postoperative-negative-pressure-pulmonary-edema-following-repetitive-laryngospasm-even-after-reversal-of-neuromuscular-blockade-by-sugammadex-a-case-report
#20
Ji Hyeon Lee, Jae Ho Lee, Min Hyun Lee, Hyun Oh Cho, Soon Eun Park
Laryngospasm, an occlusion of the glottis, can occur at any time during anesthesia, and is associated with serious perioperative complications such as hypoxia, hypercabia, aspiration, bronchospasm, arrhythmia, prolonged recovery, cardiac collapse, and eventually catastrophic death. Importantly, postoperative negative pressure pulmonary edema (NPPE) is a rare, but well described life-threatening complication related to acute and chronic upper airway obstruction. Sugammadex well known for affirmatively reducing the postoperative pulmonary complications associated with residual neuromuscular blockade may have an indirect role in triggering the negative intrathoracic pressure by raising a rapid and efficacious respiratory muscle strength in acute upper airway obstruction...
February 2017: Korean Journal of Anesthesiology
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