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Thomas Fuchs-Buder, Réka Nemes, Denis Schmartz
PURPOSE OF REVIEW: To revise the current literature on concepts for neuromuscular block management. Moreover, consequences of incomplete neuromuscular recovery on patients' postoperative pulmonary outcome are evaluated as well. RECENT FINDINGS: The incidence of residual paralysis may be as high as 70% and even small degrees of residual paralysis may have clinical consequences. Neostigmine should not be given before return of the fourth response of the train-of-four-stimulation and no more than 40-50 μg/kg should be given...
October 14, 2016: Current Opinion in Anaesthesiology
Aabid Hussain Mir, Zulfiqar Ali, Bashir Ahmad Dar, Imtiaz A Naqash, Samreena Bashir
Congenital heart defects are associated with various physiological disturbances. They pose anesthetic challenges for both cardiac and noncardiac surgeries. Atrioventricular septal defects are due to a developmental failure in the separation of atria and the ventricles into separate chambers and failure in the separation of mitral and tricuspid valves. We present a case of a child (1½ years), weighing 10 kg, diagnosed as congenital hydrocephalus who was planned for ventriculoperitoneal shunt. Child was having an oxygen saturation of 76% on room air...
September 2016: Anesthesia, Essays and Researches
Vandana Pandey, B K Mohindra, Gurdip Singh Sodhi
OBJECTIVE: To study the efficacy and safety of intrathecal neostigmine at dose of 50 μg and 150 μg as an adjuvant to bupivacaine for postoperative analgesia under spinal anesthesia. MATERIALS AND METHODS: 75 patients of either sex, belonging to American Society of Anesthesiologists (ASA) physical status I and II in the age group of 30-65 years scheduled to undergo lower abdominal and lower limb surgeries were allocated randomly into 3 groups of 25 each. Spinal anesthesia was administered in Group I (control group) with 12...
September 2016: Anesthesia, Essays and Researches
S Parthasarathy, R Sripriya, N Krishnaveni
Intestinal obstruction is associated with significant morbidity and mortality. Scientific assessment of the cause, site of obstruction, appropriate correction of the fluid deficit and electrolyte imbalance with preoperative stabilization of blood gases is ideal as a preoperative workup. Placement of a preoperative epidural catheter especially in the thoracic interspace takes care of perioperative pain and stress reduction. Intraoperative management by controlled general anesthesia administering a relative high inspired fraction of oxygen with invasive monitoring in selected sick cases is mandatory...
September 2016: Anesthesia, Essays and Researches
Özgür Yağan, Nilay Taş, Tuğçe Mutlu, Volkan Hancı
BACKGROUND AND OBJECTIVES: The aim of our study is to compare the effects of sugammadex and neostigmine, used for neuromuscular blockage antagonism, on postoperative nausea and vomiting (PONV). METHODS: Our study was completed with 98 ASA I-II risk patients undergoing endotracheal intubation under general anesthesia. At the end of the surgery patients were randomly allocated into two groups given 2mgkg(-1) sugammadex (Group S) or 50μgkg(-1) neostigmine plus 0.2mgkg(-1) atropine (Group N)...
September 28, 2016: Revista Brasileira de Anestesiologia
Gulay Gunduz Gul, Ayse B Ozer, Ismail Demirel, Ahmet Aksu, Omer L Erhan
STUDY OBJECTIVE: Sugammadex is an alternative drug to traditional decurarization by cholinesterase inhibitors. It has been examined the effect of sugammadex on steroid hormones in this study. DESIGN: Randomized clinical trial. SETTING: The study was conducted in a University Teaching Hospital from January 2013 to May 2014. PATIENTS: Fifty male patients between 18 and 45years of age with an American Society of Anesthesiology (ASA) class I or II undergoing elective lower extremity surgery were included in this study...
November 2016: Journal of Clinical Anesthesia
Seon-Young Park, Duane Burton, Irene Busciglio, Deborah Eckert, Michael Camilleri
Background/Aims: After exclusion of structural diseases, chronic constipation may be associated with normal or slow transit or rectal evacuation disorders. We evaluated: (1) clinical features and anorectal function, (2) difference of regional colonic transit according to the presence or absence of evacuation disorders, and (3) association of colonic transit with gender in patients with objectively slow colonic transit. Methods: We reviewed electronic medical records of 1553 constipated patients evaluated by a single gastroenterologist from 1994-2015 at a tertiary medical center...
September 25, 2016: Journal of Neurogastroenterology and Motility
Matthieu Cachemaille, Magnus Olofsson, Françoise Livio, Patrizio Pascale, Tobias Zingg, Yann Boegli
No abstract text is available yet for this article.
June 23, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Thiago Carrazoni, Marines de Avila Heberle, Ana Paula Artusi Perin, Ana Paula Zanatta, Polyana Veloso Rodrigues, Fabiola Duarte Machado Dos Santos, Carlos Gabriel Moreira de Almeida, Ricardo Vaz Breda, Douglas Silva Dos Santos, Paulo Marcos Pinto, Jaderson Costa da Costa, Celia Regina Carlini, Cháriston André Dal Belo
BACKGROUND: Ureases of Canavalia ensiformis are natural insecticides with a still elusive entomotoxic mode of action. We have investigated the mechanisms involved in the neurotoxicity induced by Jack Bean Urease (JBU) in Nauphoeta cinerea (Olivier). METHODS: To carry out this study we have employed biochemical and neurophysiological analysis of different cockroach organ systems. RESULTS AND CONCLUSIONS: The injection of the insects with JBU (0...
August 10, 2016: Toxicology
Young Ju Won, Byung Gun Lim, Dong Kyu Lee, Heezoo Kim, Myoung Hoon Kong, Il Ok Lee
BACKGROUND: Previous studies have shown that sugammadex, a modified γ-cyclodextrin, is a well-tolerated agent for the reversal of neuromuscular blockade (NMB) induced by a steroidal neuromuscular blocking drug in adult patients. However, its use has not been reviewed in pediatric patients. The aim of this meta-analysis was to evaluate the efficacy and safety of sugammadex in the reversal of rocuronium-induced NMB during surgery under general anesthesia in pediatric patients. METHODS: A literature search was performed using the Pubmed, EMBASE: Drugs and pharmacology, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews...
August 2016: Medicine (Baltimore)
Turker Sengul, Ayten Saracoglu, Sibel Sener, Olgac Bezen
Wolff-Parkinson-White (WPW) syndrome is a rare pre-excitation syndrome which develops when atrioventricular conduction occurs through a pathologic accessory pathway known as the bundle of Kent instead of atrioventricular node, hence resulting in tachycardia. Patients with WPW syndrome may experience various symptoms arising from mild-to-moderate chest disease, palpitations, hypotension, and severe cardiopulmonary dysfunction. These patients are most often symptomatic because of cardiac arrhythmias. In this case report, we present an uneventful anesthetic management of a pregnant patient with WPW syndrome undergoing cesarean delivery...
September 2016: Journal of Clinical Anesthesia
Jianqiao Zhang, Leiming Zhang, Xue Sun, Yanting Yang, Liang Kong, Chengwen Lu, Guangyao Lv, Tian Wang, Hongbo Wang, Fenghua Fu
Acetaminophen (APAP) is widely used as an analgesic and antipyretic agent, but it may induce acute liver injury at high doses. Alzheimer's disease patients, while treated with acetylcholinesterase inhibitor (AChEI), may take APAP when they suffer from cold or pain. It is generally recognized that inhibiting acetylcholinesterase activity may also result in liver injury. To clarify whether AChEI could deteriorate or attenuate APAP hepatotoxicity, the effects of AChEI on APAP hepatotoxicity were investigated. Male C57BL/6J mice were administrated with the muscarinic acetylcholine receptor (mAChR) blocker atropine (Atr), or classic α7 nicotine acetylcholine receptor (α7nAChR) antagonist methyllycaconitine (MLA) 1 hour before administration of AChEIs-donepezil (4 mg/kg), rivastigmine (2 mg/kg), huperzine A (0...
November 2016: Journal of Pharmacology and Experimental Therapeutics
Stephan R Thilen, Sanjay M Bhananker
This review provides recommendations for anesthesia providers who may not yet have quantitative monitoring and sugammadex available and thus are providing care within the limitations of a conventional peripheral nerve stimulator (PNS) and neostigmine. In order to achieve best results, the provider needs to understand the limitations of the PNS. The PNS should be applied properly and early. All overdosing of neuromuscular blocking drugs should be avoided and the intraoperative neuromuscular blockade should be maintained only as deep as necessary...
2016: Current Anesthesiology Reports
Catherine M Bulka, Maxim A Terekhov, Barbara J Martin, Roger R Dmochowski, Rachel M Hayes, Jesse M Ehrenfeld
BACKGROUND: Residual postoperative paralysis from nondepolarizing neuromuscular blocking agents (NMBAs) is a known problem. This paralysis has been associated with impaired respiratory function, but the clinical significance remains unclear. The aims of this analysis were two-fold: (1) to investigate if intermediate-acting NMBA use during surgery is associated with postoperative pneumonia and (2) to investigate if nonreversal of NMBAs is associated with postoperative pneumonia. METHODS: Surgical cases (n = 13,100) from the Vanderbilt University Medical Center National Surgical Quality Improvement Program database who received general anesthesia were included...
October 2016: Anesthesiology
Anis Baraka
No abstract text is available yet for this article.
June 2016: Middle East Journal of Anesthesiology
Thomas Fuchs-Buder
No abstract text is available yet for this article.
August 2016: Anaesthesia, Critical Care & Pain Medicine
Kalman F Szucs, Aniko Nagy, Gyorgy Grosz, Zita Tiszai, Robert Gaspar
AIM: Gastrointestinal motility disorders are presumed to be associated with abnormalities of the generation of slow-wave electric impulses. A requirement for the development of non-invasive clinical methods for the diagnosis of motility disorders is the identification of these signals. We set out to separate and characterize the signals from the various sections of the gastrointestinal tract and to detect changes in the smooth muscle electromyography (SEMG) signals. METHODS: Partially resected (stomach-small intestine, stomach-large intestine or small and large intestine) or non-resected male SPRD rats were measured under deep anaesthesia...
July 27, 2016: Journal of Pharmacological and Toxicological Methods
K D Peker, M Cikot, M A Bozkurt, B Ilhan, B Kankaya, S Binboga, H Seyit, H Alis
BACKGROUND: Performance of urgent colonoscopy for the purposes of diagnosis and treatment of Ogilvie's syndrome remains controversial. However, no trials have directly compared neostigmine with endoscopic therapy. This study aimed to compare the effect of neostigmine and colonoscopic decompression in the treatment of Ogilvie's syndrome. METHODS: This study was designed as a retrospective, non-randomized clinical study of sequential patients. Patients who were diagnosed as having acute colonic pseudo-obstruction were separated into two groups after conservative treatment...
July 18, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Edoardo De Robertis, Geremia Zito Marinosci, Giovanni Marco Romano, Ornella Piazza, Michele Iannuzzi, Fabrizio Cirillo, Stefania De Simone, Giuseppe Servillo
BACKGROUND: Neuromuscular block (NMB) monitoring and use of reversal agents accelerate the recovery time and improve the workflow in the operating room. We aimed to compare recovery times after sugammadex or neostigmine administration, and estimate the time spent in operating theater and the possible economic impact of a faster recovery, in morbidly obese patients undergoing bariatric surgery. METHODS: We conducted a retrospective study that analyzed data from records of morbidly obese patients (body mass index >40 kg/m(2)) undergoing elective laparoscopic bariatric surgery in which sugammadex or neostigmine were used to reverse NMB...
2016: ClinicoEconomics and Outcomes Research: CEOR
Bon-Wook Koo, Ah-Young Oh, Kwang-Suk Seo, Ji-Won Han, Ho-Seong Han, Yoo-Seok Yoon
BACKGROUND: The beneficial effects of deep blockade are not fully known. In this study, we evaluated the effect of deep neuromuscular blockade on surgical conditions during laparoscopic cholecystectomy under low-pressure pneumoperitoneum. METHODS: Patients undergoing elective laparoscopic cholecystectomy were randomized to either the moderate group (train-of-four count of 1 or 2) or deep group (posttetanic count of 1 or 2). Neuromuscular blockade was induced and maintained with rocuronium; it was reversed with sugammadex in the deep group and with neostigmine in the moderate group...
July 12, 2016: World Journal of Surgery
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