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Acceleromyography

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https://www.readbyqxmd.com/read/29704050/the-pringle-maneuver-reduces-the-infusion-rate-of-rocuronium-required-to-maintain-surgical-muscle-relaxation-during-hepatectomy
#1
Akira Kajiura, Osamu Nagata, Masamitsu Sanui
INTRODUCTION: We investigated the continuous infusion rates of rocuronium necessary to obtain the surgical muscle relaxation before, during, and after the Pringle maneuver on patients who underwent hepatectomy. METHODS: Fifteen patients were induced by total intravenous anesthesia with propofol. After obtaining the calibration of acceleromyography, the patient was intubated with rocuronium 0.6 mg/kg. Fifteen minutes after initial rocuronium injection, the continuous infusion was started at 7...
April 27, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29628555/the-role-of-bolus-injection-of-saline-with-arm-elevation-on-rocuronium-onset-time-a-randomized-control-study
#2
Malavika Kulkarni, L S Chuchendra, P J Bhavya
Background: The onset time of neuromuscular blockade is a crucial time associated with the risk of hypoxia and pulmonary aspiration. Various strategies have been undertaken to shorten this onset time. Therefore, we investigated the effects of bolus of 20 ml saline followed by limb elevation after administration of rocuronium in a dose of 0.6 mg/kg to study the onset time. Methodology: Thirty patients were randomly allocated to the bolus saline group or control group...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29486876/bias-limits-of-agreement-and-percent-errors-between-acceleromyography-and-mechanomyography-in-anesthetized-dogs
#3
D M Sakai, M Romano, C T Tseng, A Flanders, M Martin-Flores
This study compared measurements of neuromuscular function with mechanomyography (MMG) and acceleromyography (AMG) in nine anesthetized dogs receiving 0.1mg/kg vecuronium intravenously. Train-of-four (TOF) stimulation was applied to each ulnar nerve every 15s. The resulting amplitude of the first twitch (T1) and the TOF ratio were measured with both monitors. The baseline TOF ratio (prior to vecuronium), onset time (time of injection to T1<5%), recovery index (time between T1 values of 25% and 75%) and duration of neuromuscular block (injection to TOF 0...
March 2018: Veterinary Journal
https://www.readbyqxmd.com/read/29467022/recovery-of-muscle-function-after-deep-neuromuscular-block-by-means-of-diaphragm-ultrasonography-and-adductor-of-pollicis-acceleromyography-with-comparison-of-neostigmine-vs-sugammadex-as-reversal-drugs-study-protocol-for-a-randomized-controlled-trial
#4
Iacopo Cappellini, Fabio Picciafuochi, Daniele Ostento, Ginevra Danti, Angelo Raffaele De Gaudio, Chiara Adembri
BACKGROUND: The extensive use of neuromuscular blocking agents (NMBAs) during surgical procedures still leads to potential residual paralyzing effects in the postoperative period. Indeed, neuromuscular monitoring in an intra-operative setting is strongly advocated. Acetylcholinesterase inhibitors can reverse muscle block, but their short half-life may lead to residual curarization in the ward, especially when intermediate or long-acting NMBAs have been administered. Sugammadex is the first selective reversal drug for steroidal NMBAs; it has been shown to give full and rapid recovery of muscle strength, thus minimizing the occurrence of residual curarization...
February 21, 2018: Trials
https://www.readbyqxmd.com/read/29378987/incidence-of-postoperative-residual-paralysis-in-a-nigerian-teaching-hospital
#5
A A Majekodunmi, O A Ikotun, O D Oladokun
BACKGROUND: Postoperative residual paralysis (PORP) is a known risk factor after general anesthesia (GA) for critical respiratory events and increased postoperative morbidity. PORP is defined as a train-of-four ratio (TOFR) of <0.9 using acceleromyography (AMG). TOFR <0.9 has been associated with increased risk of aspiration, obstruction of the upper airway and an impaired hypoxic ventilatory response. AIM: The aim of this study was to determine the incidence of PORP, associated factors related with its occurrence and critical respiratory events in the postanesthesia recovery room (PAR) at our institution...
December 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29161387/reversal-of-residual-neuromuscular-block-complications-associated-with-perioperative-management-of-muscle-relaxation
#6
J M Hunter
The use of anticholinesterases to reverse residual neuromuscular block at the end of surgery became routine practice in the 1950s. These drugs could only be used when recovery from block was established [two twitches of the train-of-four (TOF) count detectable] and concern was expressed about their cholinergic side-effects. By the 1990s, it was recognized that failure to reverse residual block adequately to a TOF ratio (TOFR) >0.7 was associated with increased risk of postoperative pulmonary complications (POPCs) following the long-acting non-depolarizing neuromuscular blocking drug (NDNMBD) pancuronium...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28818054/comparison-of-the-trapezius-and-the-adductor-pollicis-muscle-as-predictor-of-good-intubating-conditions-a-randomized-controlled-trial
#7
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
BACKGROUND: Adequate muscle relaxation is important for ensuring optimal conditions for intubation. Although acceleromyography of the adductor pollicis muscle is commonly used to assess conditions for intubation, we hypothesized that acceleromyography of the trapezius is more indicative of optimal intubating conditions. The primary outcome was the difference between both measurement sites with regard to prediction of good or acceptable intubating conditions. METHODS: Neuromuscular blockade after injection of rocuronium 0...
August 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28795964/neuromuscular-monitoring-in-the-perioperative-period
#8
Glenn S Murphy
Neuromuscular monitoring devices were introduced into clinical practice in the 1970s. Qualitative neuromuscular monitors, or peripheral nerve stimulators, provide an electrical stimulus to a motor nerve and the response of corresponding muscle subjectively evaluated. A standard peripheral nerve stimulator provides several patterns of nerve stimulation, including train-of-four (TOF), double-burst, tetanic, and post-tetanic count. Qualitative (and quantitative) monitors are needed to determine onset of neuromuscular blockade, maintain the required depth of muscle relaxation during the surgical procedure, and assess an appropriate dose of reversal agent...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28763316/effects-of-calcium-chloride-coadministered-with-neostigmine-on-neuromuscular-blockade-recovery-a-double-blind-randomised-study
#9
Jae-Woo Ju, Hyun-Chang Kim, Sehee Yoon, Deok Man Hong, Hee-Pyoung Park
BACKGROUND: Ionised calcium plays an important role in neuromuscular transmission, but its effects on the reversal of nondepolarising neuromuscular blockade have not been fully evaluated. OBJECTIVE: We examined whether calcium chloride coadministered with neostigmine could enhance the rate of neuromuscular recovery. DESIGN: Randomised double-blind trial. SETTING: A tertiary teaching hospital. PATIENTS: In total, 53 patients undergoing elective surgery under general anaesthesia with neuromuscular monitoring by acceleromyography using a TOF-Watch SX monitor...
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28739108/use-of-cis-atracurium-to-maintain-moderate-neuromuscular-blockade-in-experimental-pigs
#10
Alexandru Tutunaru, Julien Dupont, Vincent Huberty, Mostafa Ibrahim, Didier Serteyn, Charlotte Sandersen
OBJECTIVE: To determine the dose of cis-atracurium needed to produce a moderate neuromuscular blockade (NMB) in pigs. STUDY DESIGN: Prospective experimental study. ANIMALS: Seven pigs [five females and two males; median (range) body weight: 47 (36-64) kg]. METHODS: Pigs were premedicated with intramuscular midazolam (0.3 mg kg-1 ) and ketamine (7 mg kg-1 ). Anaesthesia was induced with intravenous (IV) propofol 3 (1-4) mg kg-1 and maintained with isoflurane in oxygen...
July 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28640017/reversal-of-vecuronium-induced-neuromuscular-blockade-with-low-dose-sugammadex-at-train-of-four-count-of-four-a-randomized-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
László Asztalos, Zoltán Szabó-Maák, András Gajdos, Réka Nemes, Adrienn Pongrácz, Szabolcs Lengyel, Béla Fülesdi, Edömér Tassonyi
BACKGROUND: Rocuronium-induced neuromuscular block that spontaneously recovered to a train-of-four count of four can be reversed with sugammadex 0.5 or 1.0 mg/kg. We investigated whether these doses of sugammadex can also reverse vecuronium at a similar level of block. METHODS: Sixty-five patients were randomly assigned, and 64 were analyzed in this controlled, superiority study. Participants received general anesthesia with propofol, sevoflurane, fentanyl, and vecuronium...
September 2017: Anesthesiology
https://www.readbyqxmd.com/read/28431431/an-ipsilateral-comparison-of-acceleromyography-and-electromyography-during-recovery-from-nondepolarizing-neuromuscular-block-under-general-anesthesia-in-humans-erratum
#12
(no author information available yet)
No abstract text is available yet for this article.
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28410818/-use-of-protocol-and-evaluation-of-postoperative-residual-curarization-incidence-in-the-absence-of-intraoperative-acceleromyography-randomized-clinical-trial
#13
Filipe Nadir Caparica Santos, Angelica de Fátima de Assunção Braga, Carla Josefine Barbosa de Lima Ribeiro, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho, Fernando Eduardo Feres Junqueira
OBJECTIVE: Evaluate the incidence of postoperative residual curarization (PORC) in the post-anesthesia care unit (PACU) after the use of protocol and absence of intraoperative acceleromyography (AMG). METHODS: Randomized clinical trial with 122 patients allocated into two groups (protocol and control). Protocol group received initial and additional doses of rocuronium (0.6mg.kg(-1) and 10mg, respectively); the use of rocuronium was avoided in the final 45minutes; blockade reversal with neostigmine (50μg...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28367286/effect-of-dexamethasone-on-the-onset-time-and-recovery-profiles-of-cisatracurium
#14
Keum Young So, Sang Hun Kim, Ki Tae Jung, Dong Woo Kim
BACKGROUND: The effect of dexamethasone injection on cisatracurium-induced neuromuscular block was compared according to different injection time points. METHODS: One hundred seventeen patients were randomly assigned to three groups: 8 mg of dexamethasone injected intravenously 2-3 h before anesthesia (group A), just before anesthesia induction (group B), and at the end of surgery (control group). Three minutes after anesthesia induction, intubation was performed without neuromuscular blockers, and acceleromyography was initiated...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28351497/a-preferential-delivery-method-to-investigate-direct-neuromuscular-blockade-effect-of-inhaled-anesthetics-on-skeletal-muscle
#15
Ling Ye, Pingliang Yang
Inhaled anesthetics can enhance the effect of neuromuscular blocker, but whether inhaled anesthetics such as sevoflurane have a direct effect on skeletal muscle contractility is unknown. Selectively blocking skeletal muscle may prevent the interference effect of central nervous system. So we decided to evaluate a local application of neuromuscular blocker (NMB) atracurium to prevent the general effect on skeletal muscle. In part 1, sevoflurane (a inhaled anesthetic) minimum alveolar concentrations (MAC) of 1...
April 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28030444/impact-of-reversal-strategies-on-the-incidence-of-postoperative-residual-paralysis-after-rocuronium-relaxation-without-neuromuscular-monitoring-a-partially-randomised-placebo-controlled-trial
#16
Réka Nemes, Béla Fülesdi, Adrienn Pongrácz, László Asztalos, Zoltán Szabó-Maák, Szabolcs Lengyel, Edömér Tassonyi
BACKGROUND: Electronic neuromuscular monitoring is not widely used to determine either the reversal requirements for neuromuscular block before extubation of the trachea, or to determine if there is any subsequent postoperative residual neuromuscular block (PORNB). OBJECTIVES: To investigate the incidence of PORNB using acceleromyography after spontaneous recovery of rocuronium-induced block and to compare this with the administration of sugammadex, neostigmine or a placebo...
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28006886/neuromuscular-effect-of-dexmedetomidine-on-sevoflurane-an-open-label-dose-escalation-clinical-trial
#17
Hui-Hua Ke, Huang-Hui Wu, Qi Zhu, Yan Zhang, Jin-Rong Xiao, Xiu-Zhu Su, Wan-Jing Zheng, Yu-Ping Cai, Xiao-Zhi Wu, Yu-Tong Wang, Guo-Zhong Chen
BACKGROUND: Sevoflurane presents reliable central neuromuscular effects. However, little knowledge is available regarding the interaction between sevoflurane and demedetomidine. We evaluated the neuromuscular effect of dexmedetomidine on sevoflurane in patients with normal neuromuscular transmission and calculated the 50% effective concentration (EC50). METHODS: One-hundred and forty-four ASA grade I~II patients with normal neuromuscular transmission, aged 20~60 years old, undergoing lower limbs surgery were enrolled in this open-label, dose-escalation clinical trial...
August 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27871583/sugammadex-given-for-rocuronium-induced-neuromuscular-blockade-in-infants-a-retrospect%C3%A4-ve-study
#18
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/27703625/effective-doses-of-cisatracurium-in-the-adult-and-the-elderly
#19
Jeong Ho Kim, Yoon Chan Lee, Soo Il Lee, Sang Yoong Park, So Ron Choi, Jong Hwan Lee, Chan Jong Chung, Seung Cheol Lee
BACKGROUND: There are few information about the differences of the effective dose (ED) of cisatracurium between the adult and the elderly. We investigated the ED and the onset time of cisatracurium in the adults and the elderly. METHODS: We studied two hundred patients of the adults aged 20 through 64 years and the elderly aged ≥ 65 years, with American Society of Anesthesiologists physical status I or II. Each 100 patients with 20 patients of each dose group, randomly selected from 30, 40, 50, 60 or 70 µg/kg of cisatracurium, were randomly allocated to the adults and the elderly groups...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27606613/influence-of-preoperative-oral-rehydration-on-arterial-plasma-rocuronium-concentrations-and-neuromuscular-blocking-effects-a-randomised-controlled-trial
#20
Sayaka Ishigaki, Takahiro Ogura, Ayana Kanaya, Yu Miyake, Kenichi Masui, Tomiei Kazama
BACKGROUND: The influence of preoperative rehydration on the action of rocuronium has not yet been investigated. OBJECTIVE: The objective is to evaluate the hypothesis that preoperative rehydration lowers arterial rocuronium plasma concentrations and changes its associated neuromuscular blocking effects during induction of anaesthesia. DESIGN: Randomised, single-blinded study. SETTING: A secondary hospital from October 2013 to July 2014...
January 2017: European Journal of Anaesthesiology
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