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Neuromuscular blockers

Susan R Wilcox
Weakness is common in critically ill patients, associated with prolonged mechanical ventilation and increased mortality. Corticosteroids and neuromuscular blockade (NMB) administration have been implicated as etiologies of acquired weakness in the intensive care unit. Medical literature since the 1970s is replete with case reports and small case series of patients with weakness after receiving high-dose corticosteroids, prolonged NMB, or both. Several risk factors for weakness appear in the early literature, including large doses of steroids, the dose and duration of NMB, hyperglycemia, and the duration of mechanical ventilation...
September 26, 2016: Journal of Critical Care
O H Lee, G J Choi, H Kang, C W Baek, Y H Jung, Y C Woo, J Oh, Y H Park
BACKGROUND: Sugammadex is a new agent that reverses neuromuscular blockade by aminosteroid neuromuscular blocker. This retrospective study compared the effects of sugammadex on post-operative nausea and vomiting (PONV) with those of a pyridostigmine-glycopyrrolate mixture. METHODS: We reviewed the electronic medical records of 7179 patients who had received fentanyl-based, intravenous, patient-controlled analgesia (IV-PCA) at Chung-Ang University Hospital between January 1, 2010 and December 31, 2015...
October 2, 2016: Acta Anaesthesiologica Scandinavica
Laura Rodríguez-Rubio, Julian Solis Garcia Del Pozo, Eduardo Nava, Joaquín Jordán
No abstract text is available yet for this article.
November 2016: Journal of Clinical Anesthesia
Aaron F Kopman, Mohamed Naguib
No abstract text is available yet for this article.
October 2016: Anesthesia and Analgesia
Amit Prabhakar, Alan D Kaye, Melville Q Wyche, Orlando J Salinas, Kenneth Mancuso, Richard D Urman
Pharmacological advances in anesthesia in recent decades have resulted in safer practice and better outcomes. These advances include improvement in anesthesia drugs with regard to efficacy and safety profiles. Although neuromuscular blockers were first introduced over a half century ago, few new neuromuscular blockers and reversal agents have come to market and even fewer have remained as common clinically employed medications. In recent years, newer agents have been studied and are presented in this review...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Mukul Chandra Kapoor, Sandeep Rana, Arvind Kumar Singh, Vindhya Vishal, Indranil Sikdar
BACKGROUND AND AIMS: Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. MATERIAL AND METHODS: Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively evaluated...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Ozgur Yagan, Kadir Özyilmaz, Ahmet Özmaden, Özgür Sayin, Volkan Hanci
Stiff Person Syndrome (SPS), typified by rigidity in muscles of the torso and extremities and painful episodic spasms, is a rare autoimmune-based neurological disease. Here we present the successful endotracheal intubation and application of TIVA without muscle relaxants on an SPS patient. A 46 years old male patient was operated with ASA-II physical status because of lumber vertebral compression fracture. After induction of anesthesia using lidocaine, propofol and remifentanil tracheal intubation was completed easily without neuromuscular blockage...
September 2016: Brazilian Journal of Anesthesiology
Ali Ahiskalioglu, İlker İnce, Elif Oral Ahiskalioglu, Akgun Oral, Mehmet Aksoy, Murat Yiğiter, Mehmet Emin Celikkaya, Ahmet Bedii Salman
Purpose The aim of this study is to evaluate operating conditions during general anesthesia with or without neuromuscular blocker (NMB) in patients undergoing percutaneous internal ring suturing (PIRS). Materials and Methods In this study, 40 patients, with American Society of Anesthesiologists I and II between the ages of 1 and 12 years, were randomly assigned to two groups to receive muscle relaxant with endotracheal tube (ETT) (ETT group) or without muscle relaxant with supreme laryngeal mask airway (sLMA) (LMA group)...
August 22, 2016: European Journal of Pediatric Surgery
Douglas Silva Dos Santos, Evelise Leis Carvalho, Jeferson Camargo de Lima, Ricardo Vaz Breda, Raquel Soares Oliveira, Thiago Carrazoni de Freitas, Simone Denise Salamoni, Michelle Flores Domingues, Angela Regina Piovesan, Juliano Tomazzoni Boldo, Dênis Reis de Assis, Jaderson Costa da Costa, Cháriston André Dal Belo, Paulo Marcos Pinto
Animal venoms have been widely recognized as a major source of biologically active molecules. Bothriurus bonariensis, popularly known as black scorpion, is the arthropod responsible for the highest number of accidents involving scorpion sting in Southern Brazil. Here we reported the first attempt to investigate the neurobiology of B. bonariensis venom (BBV) in the insect and mammalian nervous system. BBV (32 μg/g) induced a slow neuromuscular blockade in the in vivo cockroach nerve-muscle preparations (70 ± 4%, n = 6, p < 0...
October 25, 2016: Chemico-biological Interactions
Kristi Hylan, An-Duyen Nguyen Vu, Katherine Stammen
Stiff-person syndrome (SPS) is a neurologic disorder characterized by painful involuntary episodes of severe muscle rigidity affecting the axial muscles and extremities. Although the etiology of SPS is unknown, it is suspected to involve the synthesis of γ-aminobutyric acid (GABA). Symptoms of SPS are precipitated by sudden unexpected movements, noises, and stress. Additionally, SPS has been linked with various autoimmune disorders, including diabetes mellitus, thyroid disease, pernicious anemia, and certain cancers...
June 2016: AANA Journal
N C Godwin, L Rodriguez, S Banks, B T Major, Y Rodriguez
Introduction. Maintenance dosing of neuromuscular blocking agents is complex and varies with patient, procedure, and clinical situation. With this in mind, we sought to identify factors impacting the maintenance dosing of neuromuscular blockers as a step toward identifying best practice with respect to minimizing residual neuromuscular blockade. Methods. Cases utilizing rocuronium from July 1, 2010, to June 30, 2014, at the sponsoring institution were analyzed. Using a mixed model to account for repeated measures, patients were analyzed by dose and weight category as defined by the World Health Organization (eight categories ranging from very severely underweight to very severely obese) as well as by the administering provider's level of experience...
2016: Anesthesiology Research and Practice
Gabriel A Paz, Timothy J Gabbett, Marianna F Maia, Haroldo Santana, Humberto Miranda, Vicente Lima
BACKGROUND: The purpose of this study was to investigate the association among anthropometric, physical performance parameters, and dynamic postural control attributes of young female volleyball athletes, and to determine if differences exist in these attributes according to playing position. METHODS: Forty-three young female volleyball players participated in this study. Players were divided by position into hitters (n = 17), middle blockers (n = 8), setters (n = 10), and liberos (n = 8)...
July 6, 2016: Journal of Sports Medicine and Physical Fitness
Bianca J Levkovich, Thuy Bui, Alastair Bovell, Jason Watterson, Annette Egan, Susan G Poole, Michael J Dooley
RATIONALE, AIM AND OBJECTIVE: In Australia and New Zealand, there are no established standards for the final presentations of prepared intravenous medications in Intensive Care Units (ICUs). Variability has the potential to contribute to deficiencies in safety, efficiency and cost effectiveness. This study aimed to examine the variability in the preparation of intravenous medications in ICUs. METHODS: An electronic survey was distributed to critical care pharmacists in Australia and New Zealand via an established email group...
June 27, 2016: Journal of Evaluation in Clinical Practice
Eduardo Barbin Zuccolotto, Guilherme Coelho Machado Nunes, Rafael Soares Lopes Nogueira, Eugenio Pagnussatt Neto, José Roberto Nociti
BACKGROUND AND OBJECTIVES: Multiple sclerosis is a demyelinating disease of the brain and spinal cord, characterized by muscle weakness, cognitive dysfunction, memory loss, and personality disorders. Factors that promote disease exacerbation are stress, physical trauma, infection, surgery, and hyperthermia. The objective is to describe the anesthetic management of a case referred to urological surgery. CASE REPORT: A female patient, 44 years of age, with multiple sclerosis, diagnosed with nephrolithiasis, referred for endoscopic ureterolythotripsy...
July 2016: Brazilian Journal of Anesthesiology
Melinda Same, Jonathan Smith
No abstract text is available yet for this article.
June 2016: British Journal of Hospital Medicine
Dominik T Steck, Christine Choi, Suneeta Gollapudy, Paul S Pagel
INTRODUCTION: Sporadic inclusion body myositis (IBM) is an inflammatory myopathy characterized by progressive asymmetric extremity weakness, oropharyngeal dysphagia, and the potential for exaggerated sensitivity to neuromuscular blockers and respiratory compromise. The authors describe their management of a patient with IBM undergoing urgent orthopedic surgery. CASE PRESENTATION: An 81-year-old man with IBM suffered a left intertrochanteric femoral fracture after falling down stairs...
April 2016: Anesthesiology and Pain Medicine
Youfen Xu, Katherine Halievski, Casey Henley, William D Atchison, Masahisa Katsuno, Hiroaki Adachi, Gen Sobue, S Marc Breedlove, Cynthia L Jordan
UNLABELLED: Spinal and bulbar muscular atrophy (SBMA) in men is an androgen-dependent neuromuscular disease caused by expanded CAG repeats in the androgen receptor (AR). Whether muscle or motor neuron dysfunction or both underlies motor impairment in SBMA is unknown. Muscles of SBMA mice show significant contractile dysfunction, implicating them as a likely source of motor dysfunction, but whether disease also impairs neuromuscular transmission is an open question. Thus, we examined synaptic function in three well-studied SBMA mouse models-the AR97Q, knock-in (KI), and myogenic141 models-by recording in vitro miniature and evoked end-plate potentials (MEPPs and EPPs, respectively) intracellularly from adult muscle fibers...
May 4, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Kim De Vasconcellos, David Lee Skinner, Dhivendra Singh
BACKGROUND: Transport of the critically ill patient poses the risk of numerous complications. Hypoxaemia is one such serious adverse event and is associated with potential morbidity and mortality. It is, however, potentially preventable. OBJECTIVE: To determine the incidence of hypoxaemia on arrival in a tertiary multidisciplinary intensive care unit (ICU) and to identify risk factors for this complication. METHOD: A retrospective observational study was conducted at King Edward VIII Hospital, Durban, South Africa, from May 2013 to February 2014...
May 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Vasilije Stambolija, Tamara Perleta Stambolija, Jadranka Katancic Holjevac, Tamara Murselovic, Jelena Radonic, Viktor Duzel, Bozidar Duplancic, Sandra Uzun, Gordana Zivanovic-Posilovic, Danijela Kolenc, Domagoj Drmic, Zeljko Romic, Sven Seiwerth, Predrag Sikiric
After the demonstration of its life-saving effect in severe hyperkalemia and the recovery of skeletal muscle after injury, pentadecapeptide BPC 157 has been shown to attenuate the local paralytic effect induced by succinylcholine, in addition to systemic muscle disability (and consequent muscle damage). Hyperkalemia, arrhythmias and a rise in serum enzyme values, were counteracted in rats. Assessments were made at 3 and 30min and 1, 3, 5, and 7 days after succinylcholine administration (1.0mg/kg into the right anterior tibial muscle)...
June 15, 2016: European Journal of Pharmacology
S Manrique-Rodríguez, A C Sánchez-Galindo, C M Fernández-Llamazares, M M Calvo-Calvo, Á Carrillo-Álvarez, M Sanjurjo-Sáez
OBJECTIVES: To estimate the impact of smart pump implementation in a pediatric intensive care unit in terms of number and type of administration errors intercepted. DESIGN: Observational, prospective study carried out from January 2010 to March 2015 with syringe and great volumen infusion pumps available in the hospital. SETTING: A tertiary level hospital pediatric intensive care unit. PARTICIPANTS: Infusions delivered with infusion pumps in all pediatric intensive care unit patients...
October 2016: Medicina Intensiva
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