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Neuromuscular blocker

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https://www.readbyqxmd.com/read/27908944/use-of-neuromuscular-blockers-during-therapeutic-hypothermia-after-cardiac-arrest-a-nursing-protocol
#1
Coraline Boulila, Samia Ben Abdallah, Aude Marincamp, Vincent Coic, Romuald Lauverjat, Nicole Ericher, Wulfran Bougouin, Jean-Paul Mira, Alain Cariou, Guillaume Geri
BACKGROUND: Neuromuscular blockers used to prevent shivering during therapeutic hypothermia in comatose patients after out-of-hospital cardiac arrest are associated with adverse events. OBJECTIVE: To assess the influence of a nurse-implemented protocol on use of neuromuscular blockers in patients treated with 24-hour therapeutic hypothermia after out-of-hospital cardiac arrest. METHODS: A before and after study was done in a 24-bed cardiac arrest center...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27871555/anesthetic-implications-for-patients-with-segawa-syndrome
#2
Kathryn E Howze, Nicholas D Will, Bryan T Klassen, Juraj Sprung, Toby N Weingarten
STUDY OBJECTIVE: To characterize the perioperative course of patients with Segawa syndrome undergoing anesthetic management. DESIGN: Retrospective observational case study. SETTING: Large tertiary medical center. PATIENTS: Patients with Segawa syndrome who underwent procedures requiring anesthetic management at our institution from January 1, 2004, through July 31, 2015. MEASUREMENTS: The health records of patients with Segawa syndrome...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27863874/successful-autologous-haematopoietic-stem-cell-transplantation-for-refractory-myasthenia-gravis-a-case-report
#3
Irene Håkansson, Anna Sandstedt, Fredrik Lundin, Håkan Askmark, Ritva Pirskanen, Kristina Carlson, Fredrik Piehl, Hans Hägglund
Myasthenia gravis (MG) is an autoimmune disease, with immune reactivity against the post-synaptic endplate of the neuromuscular junction. Apart from symptomatic treatment with choline esterase blockers, many patients also require immunomodulatory treatment. Despite existing treatment options, some patients are treatment refractory. We describe a patient with severe MG refractory to corticosteroids, four oral immunosuppressants, cyclophosphamide, rituximab and bortezomib who was treated with autologous haematopoietic stem cell transplantation...
September 28, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27816131/anesthesia-patients-with-concomitant-cardiac-and-hepatic-dysfunction
#4
REVIEW
Julianne Ahdout, Michael Nurok
Anesthesia and surgery in patients with hepatic and cardiac dysfunction poses a challenge for anesthesiologists. It is imperative to optimize these patients perioperatively. Cirrhosis is associated with a wide range of cardiovascular abnormalities. Cirrhotic cardiomyopathy is characterized by blunted contractile responsiveness or systolic incompetence, and/or diastolic dysfunction. In liver disease, anesthetic drug distribution, metabolism, and elimination may be altered. Among patients with liver disease, propofol is a reasonable anesthetic choice and cisatracurium is the preferred neuromuscular blocker...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27796041/optimal-anesthetic-regimen-for-ambulatory-laser-microlaryngeal-surgery
#5
Hyub Huh, Seol Ju Park, Hyong Hwan Lim, Kwang Yoon Jung, Seung-Kuk Baek, Seung Zhoo Yoon, Hye Won Lee, Hye Ja Lim, Jang Eun Cho
OBJECTIVES/HYPOTHESIS: Laser microlaryngeal surgery (LMS) is a short operation requiring brief and intense paralysis. Adequate muscle relaxation and rapid recovery of neuromuscular function are essential for improving surgical conditions and reducing the incidence of complications during LMS. However, the ideal muscle relaxant with a rapid onset and short duration of action is not yet available. Rocuronium has rapid onset at higher doses, but with a prolonged duration of action. Sugammadex is a selective relaxant-binding agent that allows for rapid reversal of rocuronium-induced neuromuscular blockade...
October 31, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27770577/metabotropic-and-ionotropic-glutamate-receptors-mediate-the-modulation-of-acetylcholine-release-at-the-frog-neuromuscular-junction
#6
Andrei Tsentsevitsky, Leniz Nurullin, Evgeny Nikolsky, Artem Malomouzh
There is some evidence that glutamate (Glu) acts as a signaling molecule at vertebrate neuromuscular junctions where acetylcholine (ACh) serves as a neurotransmitter. In this study, performed on the cutaneous pectoris muscle of the frog Rana ridibunda, Glu receptor mechanisms that modulate ACh release processes were analyzed. Electrophysiological experiments showed that Glu reduces both spontaneous and evoked quantal secretion of ACh and synchronizes its release in response to electrical stimulation. Quisqualate, an agonist of ionotropic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic receptors and metabotropic Group I mGlu receptors, also exerted Glu-like inhibitory effects on the secretion of ACh but had no effect on the kinetics of quantal release...
October 22, 2016: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/27736708/corticosteroids-and-neuromuscular-blockers-in-development-of-critical-illness-neuromuscular-abnormalities-a-historical-review
#7
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
https://www.readbyqxmd.com/read/27696339/effects-of-sugammadex-vs-pyridostigmine-glycopyrrolate-on-post-operative-nausea-and-vomiting-propensity-score-matching
#8
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
https://www.readbyqxmd.com/read/27687446/interaction-between-magnesium-sulfate-and-neuromuscular-blockers-during-the-perioperative-period-a-systematic-review-and-meta-analysis
#9
REVIEW
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
https://www.readbyqxmd.com/read/27636579/neuromuscular-blockers-and-electroconvulsive-therapy-how-much-is-enough
#10
Aaron F Kopman, Mohamed Naguib
No abstract text is available yet for this article.
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27625489/novel-drug-development-for-neuromuscular-blockade
#11
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
https://www.readbyqxmd.com/read/27625477/nasal-mask-ventilation-is-better-than-face-mask-ventilation-in-edentulous-patients
#12
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
https://www.readbyqxmd.com/read/27591471/anesthesia-in-a-patient-with-stiff-person-syndrome
#13
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
https://www.readbyqxmd.com/read/27548910/is-neuromuscular-blocker-necessary-in-pediatric-patients-undergoing-laparoscopic-inguinal-hernia-repair-with-percutaneous-internal-ring-suturing
#14
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
https://www.readbyqxmd.com/read/27544632/bothriurus-bonariensis-scorpion-venom-activates-voltage-dependent-sodium-channels-in-insect-and-mammalian-nervous-systems
#15
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
https://www.readbyqxmd.com/read/27501653/anesthetic-considerations-of-stiff-person-syndrome-a-case-report
#16
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
https://www.readbyqxmd.com/read/27429615/the-effect-of-patient-weight-and-provider-training-and-experience-on-dosing-of-rocuronium
#17
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
https://www.readbyqxmd.com/read/27385546/physical-performance-and-positional-differences-among-young-female-volleyball-players
#18
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
https://www.readbyqxmd.com/read/27345690/variability-of-intravenous-medication-preparation-in-australian-and-new-zealand-intensive-care-units
#19
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...
December 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27343793/anesthetic-management-of-a-patient-with-multiple-sclerosis-case-report
#20
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
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