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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...
December 26, 2016: European Journal of Anaesthesiology
Hui H Ke, Huang H Wu, Qi Zhu, Yan Zhang, Jin R Xiao, Xiu Z Su, Wan J Zheng, Yu P Cai, Xiao Z Wu, Yu T Wang, Guo Z 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...
December 22, 2016: Minerva Anestesiologica
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
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
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
Shinya Taguchi, Kazumi Ono, Hidekuni Hidaka, Yusuke Koyama
PURPOSE: The purpose of this study was to elucidate whether lung-protective ventilation-induced respiratory acidosis increased the duration of neuromuscular blockade by rocuronium. METHODS: A total of 72 patients were enrolled. After the induction of general anesthesia, rocuronium 0.6 mg/kg real body weight was administered. Tidal volume and positive end-expiratory pressure were randomly assigned as either 10 ml/kg predicted body weight and 0 cmH2O (group S) or 6 ml/kg and 5 cmH2O (group L), respectively...
December 2016: Journal of Anesthesia
Sangseok Lee, Young Jin Ro, Won Uk Koh, Tomoki Nishiyama, Hong-Seuk Yang
BACKGROUND: We conducted a prospective, randomized, multicenter study to evaluate the differences in the blocking effect of different doses of rocuronium between sevoflurane- or propofol-remifentanil anesthesia in an Asian population. METHODS: A total of 368 ASA I-II patients was enrolled. Anesthesia was induced with 2.0 mg/kg propofol and 0.1 μg/kg/min remifentanil (TIVA) or 5.0 vol.% sevoflurane with 0.1 μg/kg/min remifentanil (SEVO). Tracheal intubation was facilitated at 180 s after the administration of rocuronium at 0...
August 22, 2016: BMC Anesthesiology
A Reyes, M López, F de la Gala, M I Canal Alonso, S Agustí, M Zaballos
OBJECTIVE: To determine the end-tidal desflurane concentration required for tracheal extubation in anaesthetised adults. MATERIAL AND METHODS: After hospital Ethics Committee approval, eighteen ASA I-II adult patients (19-65 years of age), who had been scheduled for elective ambulatory surgery were included in the study. Anaesthesia was induced with propofol, fentanyl 2μ, and rocuronium for intubation. Maintenance of anaesthesia was provided by desflurane in oxygen and air (40:60), and remifentanil at 0...
January 2017: Revista Española de Anestesiología y Reanimación
Manuel Martin-Flores, Augusto M Lorenzutti, Nicolás J Litterio, Victor L Rossetti, Maria P Zarazaga, César C Bonetto, Gabriela E Aguirre
OBJECTIVES: Neostigmine is routinely used to reverse non-depolarizing neuromuscular block. Given its indirect mechanism, a plateau may exist whereby increasing doses of neostigmine do not result in clinical benefit. This study was designed to measure the speed of reversal of vecuronium-induced neuromuscular block in isoflurane-anesthetized dogs after the administration of three doses of neostigmine as used in clinical practice. STUDY DESIGN: Prospective, crossover, randomized study...
June 3, 2016: Veterinary Anaesthesia and Analgesia
Tian-long Qi, Yin-hui Zhou, Jing-jing Yuan, Zhi-song Li, Zhong-yu Wang, Yan-zi Chang, Er-xian Zhao, Dan Cheng, Jun-kai Hou, Yan Tian, Ge-zi Chen, Yuan-yuan Mao, Yang Ren, Li-rong Zhang, Quan-cheng Kan, Wei Zhang
OBJECTIVE: To determine whether ABCB1 gene polymorphisms affect the time course of action of rocuronium in Chinese patients. METHODS: This study included 105 unrelated Chinese patients undergoing general anesthesia with propofol, fentanyl, and rocuronium. Neuromuscular monitoring was performed with calibrated acceleromyography. Patients were allowed to recover spontaneously from the neuromuscular block. The time interval between the first maximum depression of the train of four (TOF) and spontaneous recovery TOF ratio of 0...
June 2016: International Journal of Clinical Pharmacology and Therapeutics
Sedat Hakimoğlu, Kasım Tuzcu, Işıl Davarcı, Murat Karcıoğlu, Esra Ayhan Tuzcu, Volkan Hancı, Suzan Aydın, Hilal Kahraman, Ahmet Elbeyli, Selim Turhanoğlu
During surgery, changes in intraocular pressure (IOP) can be observed resulting from several factors, such as airway manipulations and drugs used. We aimed to investigate the effects of sugammadex and neostigmine on IOP, hemodynamic parameters, and complications after extubation. Our study comprised 60 patients, aged 18-65 years, with a risk status of the American Society of Anesthesiologists I-II who underwent arthroscopic surgery under general anesthesia. The patients were randomly assigned into two groups...
February 2016: Kaohsiung Journal of Medical Sciences
Woojun Jung, Minho Hwang, Young Ju Won, Byung Gun Lim, Myoung-Hoon Kong, Il-Ok Lee
BACKGROUND: Electromyography and acceleromyography are common neuromuscular monitoring devices. However, questions still remain regarding the use of acceleromyography in children. This study compared the calibration success rates and intubation conditions in children after obtaining the maximal blockade depending on each of the devices. METHODS: Children, 3 to 6 years old, were randomly allocated to the TOF-Watch SX acceleromyography group or the NMT electromyography group...
February 2016: Korean Journal of Anesthesiology
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
PURPOSE: Positioning for surgery can restrict access to the patient's hand, thereby limiting assessment of the response at the adductor pollicis muscle to ulnar nerve stimulation. We evaluated a novel site to assess neuromuscular block by stimulating the accessory nerve and measuring the acceleromyographic response at the trapezius muscle. METHODS: In this prospective non-blinded observational study, we assessed neuromuscular transmission in anesthetized adult female patients undergoing elective laparoscopic gynecological surgery...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Shuhei Matsui, Satoshi Tanaka, Kenkichi Kiyosawa, Toshiyuki Tanaka, Mikito Kawamata
A 39-year-old female with facioscapulohumeral muscular dystrophy (FSHD) was scheduled for thoracoscopic resection of an anterior mediastinal tumor. She had slowly progressive weakness and atrophy in the fascial and shoulder girdle muscles. General anesthesia was induced and maintained with propofol, remifentanil, and fentanyl combined with thoracic paravertebral block. Rocuronium-induced neuromuscular blockade was evaluated with acceleromyography at the corrugator supercilii, masseter, and adductor pollicis muscles...
December 2015: Masui. the Japanese Journal of Anesthesiology
Bahar Sakızcı-Uyar, Seref Çelik, Aysun Postacı, Yeşim Bayraktar, Bayazit Dikmen, Işıl Özkoçak-Turan, Ozlem Saçan
OBJECTIVES: To compare onset time, duration of action, and tracheal intubation conditions in obese patients when the intubation dose of rocuronium was based on corrected body weight (CBW) versus lean body weight (LBW) for rapid sequence induction.  METHODS: This prospective study was carried out at Numune Education and Research Hospital, Ankara, Turkey between August 2013 and May 2014. Forty female obese patients scheduled for laparoscopic surgery under general anesthesia were randomized into 2 groups...
January 2016: Saudi Medical Journal
T Loupec, D Frasca, N Rousseau, J-P Faure, O Mimoz, B Debaene
In morbidly obese patients, the speed of reversal of neuromuscular blockade with sugammadex based on ideal body weight is still matter of debate. In this single-center, randomised, double-blinded study, neuromuscular blockade was monitored in 50 patients using acceleromyography at the adductor pollicis. At the end of surgery with deep rocuronium-induced neuromuscular blockade, patients randomly received sugammadex 4 (high dose group), 2 (middle dose group), or 1 (low dose group) of ideal body weight...
March 2016: Anaesthesia
Sayaka Ishigaki, Kenichi Masui, Tomiei Kazama
BACKGROUND: Circulatory factors modify the onset time of neuromuscular-blocking drugs. Therefore, we hypothesized that infusion of a saline flush immediately after rocuronium administration would shorten the onset time without influencing the duration of the rocuronium effect. METHODS: Forty-eight patients were randomly allocated to the control or saline flush group. Anesthesia was induced and maintained with propofol and remifentanil, and all patients received 0...
March 2016: Anesthesia and Analgesia
M Martin-Flores, M D Paré, L Campoy, R D Gleed
BACKGROUND: Centronuclear myopathy (CNM) is a rare congenital condition associated with skeletal muscle weakness. Patients with CNM may have decreased acetylcholine receptor expression and a reduced number of releasable quanta. Such perturbations could affect the time-course of neuromuscular blocking agents (NMBAs) and their antagonism with cholinesterase inhibitors. As a result of the rarity of CNM, prospective data regarding NMBA use in this subpopulation is scarce. We evaluated the neuromuscular blocking effects of cisatracurium and its antagonism with neostigmine in a canine model of CNM...
December 2015: British Journal of Anaesthesia
Buwei Yu, Baoyi Ouyang, Shengjin Ge, Yan Luo, Jun Li, Dongmei Ni, Shuangfei Hu, Hui Xu, Jin Liu, Su Min, Longyun Li, Zhengliang Ma, Kangjie Xie, Changhong Miao, Xinmin Wu
OBJECTIVE: Evidences demonstrate that postoperative residual neuromuscular blockade (rNMB) is a primary and frequent anesthetic risk factor for postoperative complications. This study was designed to mitigate the paucity of data regarding the occurrence and degree of rNMB in a real-life setting. METHODS: This prospective, multicenter, anesthetist-blind, observational study enrolled 1571 Chinese adults undergoing elective open or laparoscopic abdominal surgery lasting ≤4 hours from 32 hospitals across China...
2016: Current Medical Research and Opinion
Fatma Gulcin Ozturk Arikan, Guldem Turan, Asu Ozgultekin, Zubeyir Sivrikaya, Bekir Cem Cosar, Dondu Nisa Onder
TOF (train-of-four) monitoring provides objective data in application of neuromuscular blocking agent. Thus, applicator-based differences are eliminated and optimum muscle relaxation is maintained during operation. In the present study, we aimed to compare the effects of target-controlled infusion system and standard TOF monitoring, on use of rocuronium. ASA I-II patients, who were aged between 18 and 75 years and scheduled for elective abdominal surgery at Haydarpaşa Numune Training and Research Hospital, were enrolled in the study...
October 2016: Journal of Clinical Monitoring and Computing
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