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profound neuromuscular blockade

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https://www.readbyqxmd.com/read/30004912/profound-bradycardia-and-cardiac-arrest-after-sugammadex-administration-in-a-previously-healthy-patient-a-case-report
#1
Ivanna A Sanoja, Kenneth S Toth
We report the case of a 60-year-old man who underwent open radical prostatectomy for prostate adenocarcinoma. He had no known cardiac disease or symptoms other than controlled hypertension and remote history of cocaine use. The patient was given sugammadex for reversal of neuromuscular blockade and, within 1 minute, developed severe, drug-resistant bradycardia followed by pulseless electrical activity arrest. Advanced cardiac life support was initiated and continued for 15 minutes before the return of spontaneous circulation...
July 12, 2018: A&A practice
https://www.readbyqxmd.com/read/29178460/the-adequate-rocuronium-dose-required-for-complete-block-of-the-adductor-muscles-of-the-thigh
#2
M Fujimoto, K Kawano, T Yamamoto
BACKGROUND: Rocuronium can prevent the obturator jerk during transurethral resection of bladder tumors. We investigated the adequate rocuronium dose required for complete block of the thigh adductor muscles, and its correlation with individual responses of the adductor pollicis muscle to rocuronium. METHODS: Eleven patients scheduled for transurethral resection of bladder tumors under general anesthesia were investigated. After general anesthesia induction, neuromuscular monitoring of the adductor pollicis muscle and ultrasonography-guided stimulation of the obturator nerve was commenced...
March 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29135589/safety-and-effectiveness-of-a-novel-facemask-for-positive-pressure-ventilation
#3
Tod A Brown, Tamas A Szabo, Kathryn H Bridges, Michel J Sabbagh, William R Hand, Bethany J Wolf, Robert D Warters
BACKGROUND: Manual positive pressure ventilation is an essential skill in a variety of clinical situations. The C&E technique is commonly used with standard facemasks to provide effective ventilation. The Tao mask is a novel design that allows a more ergonomic grip. A seal between the mask and face is made with downward pressure of the palm, centered on the mask, and jaw lift is achieved with 4 fingers centered under the mandible. The purpose of this study was to evaluate the safety and effectiveness of the Tao mask compared to a standard mask before and after the administration of neuromuscular blockade (NMB) using 2 previously established ventilation scales...
July 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29042841/bradycardia-in-a-pediatric-heart-transplant-recipient-is-it-the-sugammadex
#4
Adele King, Aymen Naguib, Joseph D Tobias
Sugammadex is a novel pharmacologic agent that is used to selectively reverse the effects of the neuromuscular blocking agents rocuronium and vecuronium. Various advantages have been reported when comparing its reversal of neuromuscular blockade to that achieved with acetylcholinesterase inhibitors (neostigmine). In heart transplant recipients, bradycardia may occur following the administration of acetylcholinesterase inhibitors, due to the denervation of the heart. Theoretically, the combination of rocuronium and sugammadex could be advantageous in this clinical scenario to avoid the potential bradycardia resulting from neostigmine administration...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28716645/update-in-management-of-severe-hypoxemic-respiratory-failure
#5
REVIEW
Dharani Kumari Narendra, Dean R Hess, Curtis N Sessler, Habtamu M Belete, Kalpalatha K Guntupalli, Felix Khusid, Charles Mark Carpati, Mark Elton Astiz, Suhail Raoof
Mortality related to severe-moderate and severe ARDS remains high. We searched the literature to update this topic. We defined severe hypoxemic respiratory failure as Pao2 /Fio2  < 150 mm Hg (ie, severe-moderate and severe ARDS). For these patients, we support setting the ventilator to a tidal volume of 4 to 8 mL/kg predicted body weight (PBW), with plateau pressure (Pplat) ≤ 30 cm H2 O, and initial positive end-expiratory pressure (PEEP) of 10 to 12 cm H2 O. To promote alveolar recruitment, we propose increasing PEEP in increments of 2 to 3 cm provided that Pplat remains ≤ 30 cm H2 O and driving pressure does not increase...
October 2017: Chest
https://www.readbyqxmd.com/read/28442963/sugammadex-to-reverse-neuromuscular-blockade-and-provide-optimal-conditions-for-motor-evoked-potential-monitoring
#6
Mehdi Trifa, Senthil Krishna, Ajay D'Mello, Mumin Hakim, Joseph Drew Tobias
Sugammadex is a novel pharmacologic agent, which reverses neuromuscular blockade (NMB) via a mechanism that differs completely from acetylcholinesterase inhibitors. By encapsulating rocuronium, sugammadex can provide recovery of neuromuscular function even when there is a profound degree of NMB. We report anecdotal experience with the use of sugammadex to reverse NMB to facilitate intraoperative neurophysiological monitoring (motor evoked potentials) in an adolescent with scoliosis during posterior spinal fusion...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27871583/sugammadex-given-for-rocuronium-induced-neuromuscular-blockade-in-infants-a-retrospect%C3%A4-ve-study
#7
Ozlem Ozmete, Cagla Bali, Oya Yalcin Cok, Hatice Evren Eker Turk, Nesrın Bozdogan Ozyilkan, Soner Civi, Anıs Aribogan
STUDY OBJECTIVE: To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients. DESIGN: Retrospective observational study. SETTING: University teaching hospital. PATIENTS: Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27755068/clinical-practice-guidelines-for-sustained-neuromuscular-blockade-in-the-adult-critically-ill-patient
#8
REVIEW
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27555184/reversal-of-profound-neuromuscular-blockade-with-sugammadex-in-an-infant-after-bronchial-foreign-body-removal
#9
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/26952225/prophylactic-use-of-pregabalin-for-prevention-of-succinylcholine-induced-fasciculation-and-myalgia-a-randomized-double-blinded-placebo-controlled-study
#10
RANDOMIZED CONTROLLED TRIAL
Vinit K Srivastava, Sanjay Agrawal, Vikrant K Nimbhorkar, Abhishek Mishra, Sunil Sharma, Prasanta K Panda
BACKGROUND: Succinylcholine is commonly used to achieve profound neuromuscular blockade of rapid onset and short duration. OBJECTIVE: The present study compared the efficacy of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia. DESIGN: Prospective, randomized, placebo controlled, double blinded study. MATERIALS AND METHODS: Patients of both genders undergoing elective spine surgery were randomly assigned to two groups...
March 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/26847540/-prophylactic-use-of-pregabalin-for-prevention-of-succinylcholine-induced-fasciculation-and-myalgia-a-randomized-double-blinded-placebo-controlled-study
#11
Vinit K Srivastava, Sanjay Agrawal, Vikrant K Nimbhorkar, Abhishek Mishra, Sunil Sharma, Prasanta K Panda
BACKGROUND: Succinylcholine is commonly used to achieve profound neuromuscular blockade of rapid onset and short duration. OBJECTIVE: The present study compared the efficacy of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia. DESIGN: Prospective, randomized, placebo controlled, double blinded study. MATERIALS AND METHODS: Patients of both genders undergoing elective spine surgery were randomly assigned to two groups...
March 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/26569427/the-effect-of-anesthetic-choice-sevoflurane-versus-desflurane-and-neuromuscular-management-on-speed-of-airway-reflex-recovery
#12
RANDOMIZED CONTROLLED TRIAL
Rachel Eshima McKay, Kathryn T Hall, Nancy Hills
BACKGROUND: Nonintubated patients receiving sevoflurane have slower protective airway reflex recovery after anesthesia compared with patients receiving desflurane. We asked whether this difference would remain significant among intubated patients receiving rocuronium or whether the impact of variable neuromuscular recovery would predominate and thus minimize differences between anesthetics. METHODS: After obtaining written informed consent, patients were randomly assigned to receive sevoflurane (n = 41) or desflurane (n = 40), with neuromuscular monitoring by quantitative train-of-four (TOF) method using accelerometry...
February 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26265279/comparison-of-the-effectiveness-of-low-pressure-pneumoperitoneum-with-profound-muscle-relaxation-during-laparoscopic-donor-nephrectomy-to-optimize-the-quality-of-recovery-during-the-early-post-operative-phase-study-protocol-for-a-randomized-controlled-clinical
#13
RANDOMIZED CONTROLLED TRIAL
Denise M D Özdemir-van Brunschot, Gert J Scheffer, Albert Dahan, Janneke E E A Mulder, Simone A A Willems, Luuk B Hilbrands, Frank C H d'Ancona, Rogier A R T Donders, Kees J H M van Laarhoven, Michiel C Warlé
BACKGROUND: Since technique modifications of laparoscopic donor nephrectomy, e.g. retroperitoneoscopic donor nephrectomy or hand-assistance, have not shown significant benefit regarding safety or improvement of recovery, further research should focus on improving postoperative recovery. The use of low pressure pneumoperitoneum has shown to significantly reduce postoperative pain after laparoscopy. To facilitate the use of low pressure pneumoperitoneum, deep neuromuscular block will be used...
August 12, 2015: Trials
https://www.readbyqxmd.com/read/26240540/comparative-study-between-sugammadex-and-neostigmine-in-neurosurgical-anesthesia-in-pediatric-patients
#14
Ayman A Ghoneim, Mohammed A El Beltagy
BACKGROUND: Postoperative recurarization remains a risk following the use of the conventional neuromuscular blocking agents. In addition, none of the commonly used reversal agents, such as neostigmine or edrophonium are capable of reliably reversing profound blockade. The present comparative and randomized study investigated the use of sugammadex for reversing profound neuromuscular blockade (NMB) in pediatric neurosurgical patients undergone posterior fossa tumor excision. PATIENTS AND METHODS: Forty pediatric patients undergoing elective craniotomy for posterior fossa tumor excision were randomly divided into either of neostigmine or sugammadex group in which muscle relaxant was reversed at the end of anesthesia either with neostigmine 0...
July 2015: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/26225497/efficacy-and-safety-of-sugammadex-in-the-reversal-of-deep-neuromuscular-blockade-induced-by-rocuronium-in-patients-with-end-stage-renal-disease-a-comparative-prospective-clinical-trial
#15
COMPARATIVE STUDY
Camila M de Souza, Maria A Tardelli, Helio Tedesco, Natalia N Garcia, Mario P Caparros, Jose A Alvarez-Gomez, Itamar S de Oliveira Junior
BACKGROUND: Renal failure affects the pharmacology of nondepolarizing neuromuscular blockers making recovery of neuromuscular function unpredictable. Sugammadex antagonises rocuronium-induced neuromuscular blockade by encapsulating rocuronium, creating a stable complex molecule that is mainly excreted by the kidneys. Previous studies suggest that sugammadex is effective in reversing moderate neuromuscular block in the presence of renal failure, but no data are available regarding reversal of profound neuromuscular block in patients with renal failure...
October 2015: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/26058553/reversal-of-neuromuscular-block-in-companion-animals
#16
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/25713515/modulation-of-spontaneous-locomotor-and-respiratory-drives-to-hindlimb-motoneurons-temporally-related-to-sympathetic-drives-as-revealed-by-mayer-waves
#17
Jacob Wienecke, Manuel Enríquez Denton, Katinka Stecina, Peter A Kirkwood, Hans Hultborn
In this study we investigated how the networks mediating respiratory and locomotor drives to lumbar motoneurons interact and how this interaction is modulated in relation to periodic variations in blood pressure (Mayer waves). Seven decerebrate cats, under neuromuscular blockade, were used to study central respiratory drive potentials (CRDPs, usually enhanced by added CO2) and spontaneously occurring locomotor drive potentials (LDPs) in hindlimb motoneurons, together with hindlimb and phrenic nerve discharges...
2015: Frontiers in Neural Circuits
https://www.readbyqxmd.com/read/25699129/improving-the-functionality-of-intra-operative-nerve-monitoring-during-thyroid-surgery-is-lidocaine-an-option
#18
Ramasamy Govindarajan, Ajay Shah, Vemuru Sunil Reddy, Vellore Parithivel, Saiganesh Ravikumar, Dave Livingstone
Intra-operative nerve monitoring (IONM) is rapidly becoming a standard of care in many institutions across the country. In the absence of neuromuscular blocking agents to facilitate the IONM, the depth of anesthesia required to abolish the laryngo tracheal reflexes often results in profound hemodynamic instability during surgery, necessitating the use of large doses of sympathomimetic amines. The excessive alpha and beta adrenergic effects exhibited by these agents are undesirable in the presence of cardiovascular co-morbidities...
April 2015: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/25199193/colistin-mediated-neurotoxicity
#19
Subeer Wadia, Betty Tran
We describe a 51-year-old man who developed renal and neural toxicity after the administration of colistin. He developed respiratory apnoea, neuromuscular blockade and severe comatose encephalopathy with the lack of brainstem reflexes. After discontinuation of the antibiotic, he made a prompt recovery to his baseline neurological function. The case illustrates the importance of recognising the toxicities associated with colistin. Although recent literature details its nephrotoxicity, current data have been discordant with the rare cases of respiratory apnoea or neuromuscular blockade once cited over 30 years ago...
2014: BMJ Case Reports
https://www.readbyqxmd.com/read/25024474/effects-of-pretreatment-with-different-neuromuscular-blocking-agents-on-facilitation-of-intubation-with-rocuronium-a-prospective-randomized-comparative-study
#20
Ds Shashank, N Ratan Singh, L Kameshwar Singh
BACKGROUND AND AIMS: Priming principle refers to administration of a small dose of non-depolarising blocker, which when followed by a large intubating dose produces a relatively rapid and profound blockade to ensure suitable conditions for endotracheal intubation. We aimed to compare the effects of rocuronium, vecuronium, and atracurium as "pretreatment" drugs on intubating conditions with rocuronium facilitated endotracheal intubation. METHODS: This double-blinded, randomised controlled prospective study was carried out at a tertiary health care hospital on patients undergoing surgical procedures under general anaesthesia...
May 2014: Indian Journal of Anaesthesia
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