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"Sugammadex" AND "Emergency"

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https://www.readbyqxmd.com/read/30236580/sugammadex-rescue-in-avoiding-intensive-care-unit-admission-in-an-octogenarian-undergoing-emergency-laparotomy
#1
Soon Eu Chong, Rhendra Hardy Mohamad Zaini, Wan Fadzlina, Al Jadidi Sulaiman, Vivekananda Gunasekaran
Postlaparotomy management for elderly patients with underlying comorbidities is always a challenge because of poor cardiorespiratory reserves and prolonged effect of anesthetic drugs. For these reasons, such patients usually require intensive care unit (ICU) admission in the postoperative period. We report a case of an 85-year-old chronic smoker with controlled diabetes mellitus who needed an emergency laparotomy for a perforated gastric ulcer. Unfortunately, there was a shortage of ICU backup. With the successful conduct of an early surgery using combined general and regional anesthesia, the use of sugammadex (Bridion, Merck Sharp & Dohme Corp, Oss, the Netherlands) as a reversal agent, a skilled surgeon, and good postanesthesia care, the patient did not require ICU admission...
October 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/30236301/ultra-rapid-reversal-of-rocuronium-induced-paralysis-with-sugammadex-in-the-emergency-department
#2
Makenna A Smack, Meredith Moore, Chris Hong, Dante Gravino
No abstract text is available yet for this article.
September 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29962259/sugammadex-affects-emergence-agitation-in-children-undergoing-strabismus-surgery
#3
Young Sung Kim, Jae Ryung Cha, Yoon Sook Lee, Woon Young Kim, Jae Hwan Kim, Yun Hee Kim
Objective Emergence agitation (EA) has a multifactorial origin, and the effect of sugammadex on EA has not been established. We investigated the effect of sugammadex on EA incidence and severity. Methods We performed a retrospective study of children aged 1 to 13 years who underwent strabismus surgery. Patients received sugammadex or conventional neuromuscular reversal agents. The primary outcome variables were EA incidence and severity. Secondary outcome variables were postoperative fentanyl use, postoperative nausea and vomiting, time from reversal agent administration to extubation, time from the end of surgery to arrival in the post-anesthesia care unit (PACU) and time spent in the PACU...
September 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29843504/initial-experience-with-the-unrestricted-introduction-of-sugammadex-at-a-large-academic-medical-center-a-retrospective-observational-study-examining-postoperative-mechanical-ventilation-and-efficiency-outcomes
#4
Vikas N O'Reilly-Shah, Grant C Lynde, Matthew L Mitchell, Carla L Maffeo, Craig S Jabaley, Francis A Wolf
BACKGROUND: Sugammadex rapidly reverses deep neuromuscular blockade, but owing to cost, questions remain about its optimal utilization. After the unrestricted introduction of sugammadex at Emory University Hospital, we hypothesized that reductions would be demonstrated in the primary outcome of post-anesthesia care unit (PACU) mechanical ventilation (MV) and secondary outcomes of PACU length of stay (LOS) and emergence time (surgery end to anesthesia end time in the PACU). METHODS: This retrospective observational study included patients undergoing general anesthesia over a 12-month period...
October 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29209787/-different-levels-of-experience-with-anesthetic-agents-of-german-emergency-physicians-results-of-an-online-survey
#5
A Luckscheiter, M Fischer, W Zink
BACKGROUND AND OBJECTIVE: In 2015 practice management guidelines on prehospital emergency anesthesia in adults were published in Germany. The aim of the present study was to evaluate whether emergency physicians follow these guidelines in daily practice and to assess their level of experience with the use of anesthetic agents. MATERIAL AND METHODS: In an online survey the way of induction of preclinical anesthesia (including preoxygenation time and applied monitoring techniques) was assessed with the help of virtual scenarios based on the guidelines...
January 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29041919/preparing-for-the-unexpected-special-considerations-and-complications-after-sugammadex-administration
#6
REVIEW
Hajime Iwasaki, J Ross Renew, Takayuki Kunisawa, Sorin J Brull
Sugammadex, a modified gamma-cyclodextrin, has changed clinical practice of neuromuscular reversal dramatically. With the introduction of this selective relaxant binding agent, rapid and reliable neuromuscular reversal from any depth of block became possible. Sugammadex can reverse neuromuscular blockade without the muscarinic side effects typically associated with the administration of acetylcholinesterase inhibitors. However, what remained unchanged is the incidence of residual neuromuscular blockade. It is known that sugammadex cannot always prevent its occurrence, if appropriate dosing is not chosen based on the level of neuromuscular paralysis prior to administration determined by objective neuromuscular monitoring...
October 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29020936/staggering-the-dose-of-sugammadex-lowers-risks-for-severe-emergence-cough-a-randomized-control-trial
#7
RANDOMIZED CONTROLLED TRIAL
Loh P S, M M Miskan, Chin Y Z, R A Zaki
BACKGROUND: Cough on emergence has been reported as a common adverse reaction with sugammadex reversal. We investigated if staggering the dose of sugammadex will reduce emergence cough in a single-center, randomized, double-blinded study. METHODS: A hundred and twenty ASA 1-3 adults were randomly reversed with 1 mg/kg sugammadex prior to extubation followed by another 1 mg/kg immediately after extubation (staggered group), single dose of 2 mg/kg sugammadex (single bolus group) or neostigmine 0...
October 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28483312/current-knowledge-and-management-of-hypersensitivity-to-perioperative-drugs-and-radiocontrast-media
#8
Karen S Hsu Blatman, David L Hepner
Perioperative anaphylaxis is an iatrogenic clinical condition, most often after anesthetic induction. Several mechanisms are implicated, including IgE- and non-IgE-mediated mechanisms. Perioperative anaphylaxis tends to be severe and has a higher mortality rate than anaphylaxis in other settings. This is partly due to factors that impair early recognition of anaphylaxis. Neuromuscular blocking agents, latex containing products, and antibiotics are the most common etiology. Chlorhexidine and dyes are increasingly culprits...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28235515/case-report-neuromuscular-block-induced-by-rocuronium-following-sugammadex-administration
#9
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/28235495/use-of-sugammadex-in-an-octagenerian-with-myaesthenia-gravis-undergoing-emergency-laporotomy
#10
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/27789121/sugammadex-an-emerging-trigger-of-intraoperative-anaphylaxis
#11
Kok Loong Ue, Bogusia Kasternow, Annette Wagner, Ryszard Rutkowski, Krzysztof Rutkowski
No abstract text is available yet for this article.
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27755128/residual-neuromuscular-blockade-management-and-impact-on-postoperative-pulmonary-outcome
#12
REVIEW
Thomas Fuchs-Buder, Réka Nemes, Denis Schmartz
PURPOSE OF REVIEW: To revise the current literature on concepts for neuromuscular block management. Moreover, consequences of incomplete neuromuscular recovery on patients' postoperative pulmonary outcome are evaluated as well. RECENT FINDINGS: The incidence of residual paralysis may be as high as 70% and even small degrees of residual paralysis may have clinical consequences. Neostigmine should not be given before return of the fourth response of the train-of-four-stimulation and no more than 40-50 μg/kg should be given...
December 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27555184/reversal-of-profound-neuromuscular-blockade-with-sugammadex-in-an-infant-after-bronchial-foreign-body-removal
#13
Mustafa Azizoglu, Handan Birbicer, Suleyman Memis, Hakan Taşkınlar
Sugammadex is a selective chemical agent that can reverse neuromuscular blockade induced by vecuronium and rocuronium. The aim of this report is to discuss the effectiveness of sugammadex in the reversal of neuromuscular blockade in children younger than 2 years. A 16-month-old boy, weighing 10 kg, was admitted to the pediatric emergency department due to choking, cyanosis, and severe respiratory distress that occurred while he was eating peanuts. In the emergency department, the patient's condition deteriorated, and he went into respiratory arrest...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/26799963/reversing-neuromuscular-blockade-inhibitors-of-the-acetylcholinesterase-versus-the-encapsulating-agents-sugammadex-and-calabadion
#14
REVIEW
Friederike Haerter, Matthias Eikermann
INTRODUCTION: Acetylcholinesterase inhibitors (neostigmine, edrophonium) and encapsulating agents (sugammadex and calabadion) can be used to reverse residual neuromuscular blockade (NMB). AREAS COVERED: This review provides information about efficacy, effectiveness, and side effects of drugs (acetylcholinesterase inhibitors and encapsulating agents) used to reverse neuromuscular blocking agents (NMBAs). EXPERT OPINION: The therapeutic range of acetylcholinesterase-inhibitors is narrow and effectiveness studies demonstrate clinicians don't use these unspecific reversal agents effectively to increase postoperative respiratory safety...
2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/26508869/feasibility-of-full-and-rapid-neuromuscular-blockade-recovery-with-sugammadex-in-myasthenia-gravis-patients-undergoing-surgery-a-series-of-117-cases
#15
Tomas Vymazal, Martina Krecmerova, Vladimír Bicek, Robert Lischke
PURPOSE: Myasthenia gravis (MG) is an autoimmune disease interfering with neuromuscular transmission. Patients are at risk of postoperative residual curarization (PORC) if nondepolarizing muscle relaxants are used. Clinically inapparent insufficient muscle strength may result in hypoventilation and postoperative bronchopneumonia. We describe a cohort of 117 cases in which sugammadex was used in MG patients undergoing surgery with muscle relaxation with rocuronium. METHODS AND PATIENTS: We anesthetized 117 patients with MG using rocuronium and sugammadex as neuromuscular blockade reversal agent...
2015: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/26442416/-development-of-takotsubo-cardiomyopathy-during-recovery-from-general-anesthesia-a-case-report
#16
Hisayo Seno, Nobuyasu Komasawa, Yukiyo Hasegawa, Yusuke Kusaka, Osamu Umegaki, Toshiaki Minami
Takotsubo cardiomyopathy is a cardiac syndrome characterized by transient left ventricular dysfunction. A 61-year-old woman underwent laparoscopic cholecystectomy under general anesthesia. During recovery from general anesthesia, several arrhythmias occurred without cardiac collapse following desflurane discontinuation and sugammadex sodium administration. She had a chest pain after extubation, with ST segment elevation in leads aV(L) and V2-4. Emergency left ventricular angiogram revealed no significant coronary stenosis, and excessive contraction of the base and severe hypokinesis of the apex suggested Takotsubo cardiomyopathy...
August 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26437552/-a-case-of-repetitive-cardiac-arrest-due-to-coronary-vasospasm-after-sugammadex-administration
#17
Koji Hoshino, Rui Kato, Sayaka Nagasawa, Masahito Kozu, Yuji Morimoto
A 58-year-old man with no history of cardiac disease was scheduled for a cerebral aneurysm clipping surgery. Anesthesia was administered with propofol, rocuronium, fentanyl, and remifentanil. At the end of the surgery, extubation was performed 3 min after the administration of 200 mg sugammadex, along with a simultaneous blood-pressure decrease with ST elevation on lead II. Cardiopulmonary resuscitation was per- formed owing to the occurrence of lethal arrhythmia, and the patient was successfully resuscitated...
June 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26058553/reversal-of-neuromuscular-block-in-companion-animals
#18
REVIEW
Ronald S Jones, Ulrike Auer, Martina Mosing
OBJECTIVE: To review the evidence regarding the reversal of neuromuscular block (NMB) in companion animals with emphasis on the development and use of newer agents. DATABASE USED: Data sources include scientific reviews and original research publications in both human and veterinary literature using Pubmed and Scopus as search data bases. Unpublished and locally published data on reversal of NMB are presented. CONCLUSIONS: Residual NMB has been shown to increase morbidity and mortality in humans and needs to be avoided...
September 2015: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/25935840/effects-of-sugammadex-on-incidence-of-postoperative-residual-neuromuscular-blockade-a-randomized-controlled-study
#19
RANDOMIZED CONTROLLED TRIAL
B Brueckmann, N Sasaki, P Grobara, M K Li, T Woo, J de Bie, M Maktabi, J Lee, J Kwo, R Pino, A S Sabouri, F McGovern, A K Staehr-Rye, M Eikermann
BACKGROUND: This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. METHODS: Adult patients undergoing abdominal surgery received rocuronium, followed by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade...
November 2015: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/25627032/rocuronium-versus-suxamethonium-a-survey-of-first-line-muscle-relaxant-use-in-uk-prehospital-rapid-sequence-induction
#20
COMPARATIVE STUDY
Emma L Hartley, Roger Alcock
INTRODUCTION: Prehospital anaesthesia in the United Kingdom (UK) is provided by Helicopter Emergency Medical Service (HEMS) and British Association for Immediate Care (BASICS), a road-based service. Muscle relaxation in rapid sequence induction (RSI) has been traditionally undertaken with the use of suxamethonium; however, rocuronium at higher doses has comparable intubating conditions with fewer side effects. HYPOTHESIS/PROBLEM: The aim of this survey was to establish how many prehospital services in the UK are now using rocuronium as first line in RSI...
April 2015: Prehospital and Disaster Medicine
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