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C Unterbuchner, M Blobner
Neuromuscular blockade (TOF count = 0) can improve tracheal intubation and microlaryngeal surgery. It is also frequently used in many surgical fields including both nonlaparoscopic and laparoscopic surgery to improve surgical conditions and to prevent sudden muscle contractions. Currently there is a controversy regarding the need and the clinical benefits of deep neuromuscular blockade for different surgical procedures. Deep neuromuscular relaxation improves laparoscopic surgical space conditions only marginally when using low intra-abdominal pressure...
March 2018: Der Anaesthesist
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
Ömür Öztürk, Gülbin Yalçın Sezen, Handan Ankaralı, Onur Özlü, Yavuz Demiraran, Hakan Ateş, Burhan Dost
OBJECTIVE: Rocuronium is a non-depolarising, intermediate-acting, monoquaternary amino steroid and was brought into clinical use as a potentially ideal muscle relaxant. Post-operative residual curarisation (PORC) results from the prolonged effects of non-depolarising neuromuscular blocking agents. This is a common problem and seriously affects patient safety. No recent study has investigated the effects of sugammadex on smokers, which is often used to restore neuromuscular block and avoid PORC...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
Benjamin L Olesnicky, Catherine Traill, Frank B Marroquin-Harris
BACKGROUND: Postoperative residual curarisationf is a preventable cause of postoperative morbidity. Although sugammadex has been shown to reduce the risk of residual curarisation, it has not yet been shown if this directly translates to a reduction in morbidity. We aimed to demonstrate whether the introduction of unrestricted sugammadex for routine reversal changed the incidence of post-operative respiratory diagnoses and the rate of airway and respiratory complications in the post-operative care unit...
March 2017: Minerva Anestesiologica
E A Mangodt, A L Van Gasse, A Bastiaensen, I I Decuyper, A Uyttebroek, M Faber, V Sabato, C H Bridts, M M Hagendorens, L S De Clerck, D G Ebo
The last two decades have witnessed that flow-assisted analysis of in vitro-activated basophils can constitute a valuable adjunct in the in vitro diagnostic approach of immediate drug hypersensitivity reactions (IDHR). This article summarises the current experience with the basophil activation test in the diagnosis of IDHR, with particular focus on allergy to curarising neuromuscular blocking agents, antibiotics (β-lactams and fluoroquinolones), iodinated radiocontrast media and opiates.
February 2016: Acta Clinica Belgica
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
C Unterbuchner, R Ziegleder, B Graf, T Metterlein
A 61-year-old woman (57 kg, 171 cm) underwent surgery under general anaesthesia with desflurane 5.8-6.1 vol. % end-tidal, remifentanil 0.2-0.4 μg/kg/min and rocuronium 35 mg (0.61 mg/kg). On return of the second twitch in the train-of-four (TOF) stimulation measured by acceleromyography, sugammadex 120 mg (2.1 mg/kg) was given. After complete neuromuscular recovery, magnesium sulphate 3600 mg (60 mg/kg) was injected intravenously over 5 min to treat atrial fibrillation. This was associated with recurarisation with a nadir [first twitch=25%, TOF ratio (TOFR)=67%] 7 min after the start of the magnesium sulphate infusion (magnesium plasma level: 2...
April 2015: Acta Anaesthesiologica Scandinavica
Sophie Huynh-Moynot, Jean-Clair Moynot, Chloé Thill, Diane Commandeur, Mehdi Ould-Ahmed, Isabelle Drouillard
Succinylcholine is a short-term curare which degradation depends on its quick hydrolysis by butyrylcholinesterase (or pseudocholinesterase). Thus, a butyrycholinesterase deficiency, congenital or acquired, is a cause of a prolonged neuromuscular block. From an autosomal recessive inheritance, genetic deficiency remains the first etiology. The most frequently discussed variant is the atypical variant which caused a 2 hours prolonged curarisation after administration of succinylcholine. We report a patient who had a prolonged curarisation after succinylcholine's injection, due to a congenital butyrylcholinestérase deficiency and contributed by a lithium treatment...
July 2013: Annales de Biologie Clinique
Piotr Pietraszewski, Tomasz Gaszyński
BACKGROUND: Incomplete recovery of neuromuscular function following the administration of medium-acting, non- -depolarising agents is one of the most feared complications in anaesthesia. We assessed the incidence of postoperative residual curarisation (PORC) after general anaesthesia with rocuronium in elderly and young patients, and we evaluated possible complications of postoperative residual curarisation. METHODS: This observational study included 415 patients (ASA physical status I-III) who were undergoing different surgical procedures: 184 patients were aged ≥ 65 (range: 65-89) years, and 231 patients were aged 19-57 years...
April 2013: Anaesthesiology Intensive Therapy
G V Cammu, V Smet, K De Jongh, D Vandeput
Six years ago, a study performed in our department reported that the incidence of postoperative residual curarisation (PORC) was 39%. The reassessment of neuromuscular monitoring and reversal of neuromuscular block in routine anaesthetic practice is relevant now that sugammadex has become available. The incidence of PORC, defined by a train-of-four (TOF) <90%, was evaluated at post-anaesthesia care unit (PACU) arrival in patients whose neuromuscular block had been reversed with neostigmine or sugammadex and those in whom reversal was felt unnecessary (adequate spontaneous recovery)...
November 2012: Anaesthesia and Intensive Care
Dennis Döcker, Andreas Walther
The use of muscle relaxants facilitates endotracheal intubation and ameliorates the conditions of surgery. But, their use should be controlled - otherwise there will be postoperative residual curarisation which can lead to patient discomfort up to severe medical complications. Therefore, an appropriate surveillance via objective neuromuscular monitoring is essential. This article gives a review of the basic principles of muscle relaxants, their clinical application and the surveillance of their effects and degradation...
May 2012: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
B B Chrystall, C E Devine
Anaesthetised rats, used either before or after exsanguination, provided a useful preparation with which to measure muscle tension from the M. triceps surae and follow pH changes from the M. longissimus dorsi due to stimulation. With square wave pulses (5 ms duration) the minimum voltage required to elicit a tension response from the M. triceps surae was 0·1 V when applied via the tibial branch of the sciatic nerve and nearly 3 V when applied directly across the muscles. Maximum responses were achieved by 2 V applied to the nerve or 5-8 V across the muscle...
1983: Meat Science
Lennart Magnusson
Spontaneous ventilation during general anaesthesia has been shown to favour atelectasis formation and decreased functional residual capacity. Therefore, general anaesthesia is commonly associated with endotracheal intubation and mechanical ventilation. Laryngeal lesions, residual curarisation, haemodynamics impairment, but most importantly, situation of cannot ventilate-cannot intubate may occur. Recently developed anaesthetic ventilators are able to detect spontaneous ventilation (triggering) and to give a pressure-limited flow cycled assisted breath (pressure support ventilation, PSV)...
June 2010: Best Practice & Research. Clinical Anaesthesiology
No abstract text is available yet for this article.
January 18, 1947: Lancet
C Baillard
A 0.9 train-of-four ratio, measured at the thumb, is currently considered to reflect adequate recovery of neuromuscular block. Recent studies have documented that a train-of-four ratio <0.9 is associated with a decrease in chemoreceptor sensitivity to hypoxia and with a functional impairment of the pharyngeal muscles. These residual effects of neuromuscular blocking agents promote insufficient ventilatory response to hypoxia and regurgitation/aspiration. As a result, the incidence of pulmonary complications have been found to be higher in both early and late postoperative period in patients with residual curarisation...
September 2009: Annales Françaises D'anesthèsie et de Rèanimation
Alejo Rodríguez-Cattáneo, Angel Ariel Caputi
This article shows that differences in the waveforms of the electric organ discharges (EODs) from two taxa are due to the different responsiveness of their electric organs (EOs) to their previous activity (auto-excitability). We compared Gymnotus omarorum endemic to Uruguay (35 degrees South, near a big estuary), which has four components in the head to tail electric field (V(1) to V(4)), with Gymnotus sp. endemic to the south of Brazil, Paraguay and Argentinean Mesopotamia (25 degrees South, inland), which shows a fifth component in addition to the others (V(5))...
November 2009: Journal of Experimental Biology
Tomasz Gaszyński, Lukasz Szlachciński, Jakub Jakubiak, Wojciech Gaszyński
BACKGROUND: Postoperative residual curarisation (PORC) is a serious and underestimated problem and may occur even after relaxation with medium-acting non-depolarising agents. METHODS: One hundred adult patients, scheduled for elective surgical procedures, were enrolled in the study. Atracurium or cis-atracurium was used for relaxation. Neostigmine was administered for reversal at the end of surgery, at the discretion of the attending anaesthesiologist. Neuromuscular transmission was not monitored in the operating room...
January 2009: Anestezjologia Intensywna Terapia
R G Craig, J M Hunter
The pharmacodynamics and pharmacokinetics of the currently available neuromuscular blocking and reversal drugs may be altered by organ disease. Adverse effects such as prolonged neuromuscular block, postoperative residual curarisation, recurarisation, the muscarinic effects of the anticholinesterases, and the side-effects of the antimuscarinics are encountered more frequently. This review will consider these potential problems and assess the role of sugammadex in enabling the anaesthetist to avoid them. It will also present the latest knowledge regarding the safety and efficacy of sugammadex in patients with renal, hepatic, cardiovascular and pulmonary disease...
March 2009: Anaesthesia
No abstract text is available yet for this article.
July 1, 1948: Archives Internationales de Pharmacodynamie et de Thérapie
No abstract text is available yet for this article.
April 20, 1948: Acta Physiologica Scandinavica
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