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https://www.readbyqxmd.com/read/27902641/diaphragmatic-and-intercostal-electromyographic-activity-during-neostigmine-sugammadex-and-neostigmine-sugammadex-enhanced-recovery-after-neuromuscular-blockade-a-randomised-controlled-volunteer-study
#1
Guy Cammu, Tom Schepens, Nikolaas De Neve, Davina Wildemeersch, Luc Foubert, Philippe G Jorens
BACKGROUND: Electromyographic activity of the diaphragm (EMGdi) during weaning from mechanical ventilation is increased after sugammadex compared with neostigmine. OBJECTIVE: To determine the effect of neostigmine on EMGdi and surface EMG (sEMG) of the intercostal muscles during antagonism of rocuronium block with neostigmine, sugammadex and neostigmine followed by sugammadex. DESIGN: Randomised, controlled, double-blind study. SETTING: Intensive care research unit...
January 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27874086/combined-administration-of-anisodamine-and-neostigmine-rescued-acute-lethal-crush-syndrome-through-%C3%AE-7nachr-dependent-jak2-stat3-signaling
#2
Zhe-Qi Xu, Bo-Zong Shao, Ping Ke, Jian-Guo Liu, Guo-Ku Liu, Xiong-Wen Chen, Ding-Feng Su, Chong Liu
Previously we showed that Ani (anisodamine)/Neo (neostigmine) combination produced anti-shock effect via activating α7 nicotinic acetylcholine receptor (α7nAChR). In this study, we aim to investigate the therapeutic effect and underlying mechanisms of Ani/Neo combination in acute lethal crush syndrome (CS). In rat and rabbit CS models, Ani/Neo combination increased the 24 h survival rates, improved hemodynamics and decreased the levels of creatine kinase, MB isoenzyme of creatine kinase, blood urea nitrogen, creatinine, K(+) in serum...
November 22, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27871520/cisatracurium-and-rocuronium-associated-residual-neuromuscular-dysfunction-under-intraoperative-neuromuscular-monitoring-and-postoperative-neostigmine-reversal-a-single-blind-randomized-trial
#3
Paolo Feltracco, Tommaso Tonetti, Stefania Barbieri, Anna Chiara Frigo, Carlo Ori
BACKGROUND: Postoperative residual neuromuscular blockade (RNMB) is a common complication in the postanesthesia care unit (PACU), but also one of the most controversial issues. Many studies and trials demonstrated that some methods and techniques can reduce the incidence and the extent of the phenomenon. STUDY OBJECTIVE: To determine the incidence of RNMB in the PACU at standardized times after extubation with the implementation of a protocol of careful neuromuscular blockade management...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871505/operating-room-discharge-after-deep-neuromuscular-block-reversed-with-sugammadex-compared-with-shallow-block-reversed-with-neostigmine-a-randomized-controlled-trial
#4
Laurie Putz, Christophe Dransart, Jacques Jamart, Maria-Laura Marotta, Geraldine Delnooz, Philippe E Dubois
OBJECTIVE: To determine if reversing a deep or moderate block with sugammadex, compared with a shallow block reversed with neostigmine, reduces the time to operating room discharge after surgery and the time spent in the postanesthesia care unit. DESIGN: A randomized controlled trial. SETTING: Monocentric study performed from February 2011 until May 2012. PATIENTS: One hundred consenting women with American Society of Anesthesiologists grade I or II were randomized into 2 groups...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871504/efficacy-and-safety-of-sugammadex-compared-to-neostigmine-for-reversal-of-neuromuscular-blockade-a-meta-analysis-of-randomized-controlled-trials
#5
REVIEW
Michele Carron, Francesco Zarantonello, Paola Tellaroli, Carlo Ori
BACKGROUND AND OBJECTIVE: Sugammadex has been introduced for reversal of rocuronium (or vecuronium)-induced neuromuscular blockade (NMB). Although its efficacy has been established, data are conflicting whether it is safer than neostigmine traditionally used for reversing NMB. DESIGN: Meta-analysis of data about effectiveness and safety of sugammadex compared to neostigmine for reversing NMB in adults was performed using the PRISMA methodology. SETTING: University medical hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27865835/cholinesterases-inhibition-and-molecular-modeling-studies-of-piperidyl-thienyl-and-2-pyrazoline-derivatives-of-chalcones
#6
Muhammad Shakil Shah, Shafi Ullah Khan, Syeda Abida Ejaz, Saifullah Afridi, Syed Umar Farooq Rizvi, Muhammad Najam-Ul-Haq, Jamshed Iqbal
Super-activation of cholinesterases (acetylcholinesterase and butyrylcholinesterase) are linked to various neurological problems most precisely Alzheimer's disease (AD), which leads to senile dementia. Therefore, cholinesterases (AChE & BChE) inhibition are considered as a promising strategy for the treatment of Alzheimer's disease. FDA approved drugs for the treatment of AD, belong to a group of cholinesterase inhibitors. However, none of them is able to combat or completely abrogate the disease progression...
November 16, 2016: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/27854225/myasthenia-gravis-unusual-presentations-and-diagnostic-pitfalls
#7
Carmelo Rodolico, Daniela Parisi, Simona Portaro, Fiammetta Biasini, Stefano Sinicropi, Annamaria Ciranni, Antonio Toscano, Sonia Messina, Olimpia Musumeci, Giuseppe Vita, Paolo Girlanda
BACKGROUND: Myasthenia gravis (MG) is an autoimmune disorder presenting with fluctuating, fatigable muscle weakness. Initial symptoms classically involve ocular and proximal limb muscles. Rarely, MG may onset with unusual features, so it can be misdiagnosed with other neuromuscular diseases. OBJECTIVE: To describe unusual and atypical presentations of MG in a large cohort of patients, considering and discussing diagnostic difficulties and pitfalls. METHODS: We report on 21 out of 508 MG patients, coming to our department in the last 27 years and presenting with atypical or unusual features...
August 30, 2016: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/27852231/a-discrete-event-simulation-model-of-clinical-and-operating-room-efficiency-outcomes-of-sugammadex-versus-neostigmine-for-neuromuscular-block-reversal-in-canada
#8
Ralph P Insinga, Cédric Joyal, Alexandra Goyette, André Galarneau
BACKGROUND: The objective of this analysis is to explore potential impact on operating room (OR) efficiency and incidence of residual neuromuscular blockade (RNMB) with use of sugammadex (Bridion™, Merck & Co., Inc., Kenilworth, NJ USA) versus neostigmine for neuromuscular block reversal in Canada. METHODS: A discrete event simulation (DES) model was developed to compare ORs using either neostigmine or sugammadex for NMB reversal over one month. Selected inputs included OR procedure and turnover times, hospital policies for paid staff overtime and procedural cancellations due to OR time over-run, and reductions in RNMB and associated complications with sugammadex use...
November 16, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27819419/clinical-significance-of-repetitive-compound-muscle-action-potentials-in-patients-with-myasthenia-gravis-a-predictor-for-cholinergic-side-effects-of-acetylcholinesterase-inhibitors
#9
Hyo Eun Lee, Yool Hee Kim, Seung Min Kim, Ha Young Shin
BACKGROUND AND PURPOSE: Acetylcholinesterase inhibitors (AChEIs) are widely used to treat myasthenia gravis (MG). Although AChEIs are usually tolerated well, some MG patients suffer from side effects. Furthermore, a small proportion of MG patients show cholinergic hypersensitivity and cannot tolerate AChEIs. Because repetitive compound muscle action potentials (R-CMAPs) are an electrophysiologic feature of cholinergic neuromuscular hyperactivity, we investigated the clinical characteristics of MG patients with R-CMAPs to identify their clinical usefulness in therapeutic decision-making...
October 2016: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/27818682/current-trends-in-neuromuscular-blockade-management-and-monitoring-amongst-singaporean-anaesthetists
#10
Wendy H Teoh, Thomas Ledowski, Phillip S Tseng
Introduction. This survey aimed to investigate the attitudes/practice pertaining the use, management, and monitoring of neuromuscular blockade amongst Singaporean anaesthetists. Methods. All specialist accredited anaesthetists registered with the Singapore Medical Council were invited to complete an anonymous online survey. Results. The response rate was 39.5%. Neuromuscular monitoring (NM) was used routinely by only 13.1% despite the widespread availability of monitors. 82% stated residual NMB (RNMB) was a significant risk factor for patient outcome, but only 24% believed NMB monitoring should be compulsory in all paralyzed patients...
2016: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/27770778/observational-study-on-patterns-of-neuromuscular-blockade-reversal
#11
Timur Dubovoy, Michelle Housey, Scott Devine, Sachin Kheterpal
BACKGROUND: Using electronic health record data, we hypothesized that larger reversal doses are used for patients with deeper levels of neuromuscular blockade (NMB) as evidenced by the last recorded TOF measurement. We also examined if dosing regimens reflect current practice guidelines of using ideal body weight (IBW) for NMB agents and total body weight (TBW) for neostigmine. METHODS: This is a retrospective observational study of adult, ASA 1-4 patients who underwent general anaesthesia and received non-depolarizing NMB agents between 01/01/2004 and 12/31/2013...
October 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27755128/residual-neuromuscular-blockade-management-and-impact-on-postoperative-pulmonary-outcome
#12
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...
December 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27746571/anesthetic-management-of-a-child-with-complete-atrioventricular-septal-defect-and-single-ventricle-posted-for-noncardiac-surgery
#13
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
https://www.readbyqxmd.com/read/27746548/comparative-evaluation-of-different-doses-of-intrathecal-neostigmine-as-an-adjuvant-to-bupivacaine-for-postoperative-analgesia
#14
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
https://www.readbyqxmd.com/read/27746522/anesthetic-management-of-intestinal-obstruction-a-postgraduate-educational-review
#15
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
https://www.readbyqxmd.com/read/27692737/-comparison-of-the-effects-of-sugammadex-and-neostigmine-on-postoperative-nausea-and-vomiting
#16
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
https://www.readbyqxmd.com/read/27687347/the-effect-of-sugammadex-on-steroid-hormones-a-randomized-clinical-study
#17
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
https://www.readbyqxmd.com/read/27667753/regional-colonic-transit-pattern-does-not-conclusively-identify-evacuation-disorders-in-constipated-patients-with-delayed-colonic-transit
#18
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
https://www.readbyqxmd.com/read/27663634/recurrent-asystole-after-neostigmine-in-a-heart-transplant-recipient-with-end-stage-renal-disease
#19
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
https://www.readbyqxmd.com/read/27640743/central-and-peripheral-neurotoxicity-induced-by-the-jack-bean-urease-jbu-in-nauphoeta-cinerea-cockroaches
#20
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
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