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Neuromuscular blocking drugs

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https://www.readbyqxmd.com/read/28448298/anesthetic-consideration-for-neuromuscular-diseases
#1
Jeffery A Katz, Glenn S Murphy
PURPOSE OF REVIEW: The aim of this review is to examine data relating to perioperative management of the patient with neuromuscular disorders RECENT FINDINGS: Patients with pre-existing neuromuscular disorders are at risk for a number of postoperative complications that are related to anesthetic drugs that are administered intraoperatively. Careful preoperative assessment is necessary to reduce morbidity and mortality. In particular, the risk of postoperative respiratory failure and need for long-term ventilation should be reviewed with patients...
April 26, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28437264/magnesium-sulphate-improves-pulmonary-function-after-video-assisted-thoracoscopic-surgery-a-randomised-double-blind-placebo-controlled-study
#2
Hye-Min Sohn, Sang-Hoon Jheon, Sunwoo Nam, Sang-Hwan Do
BACKGROUND: Reduced lung volumes are unavoidable after lung resection surgery. Magnesium sulphate (MgSO4) administration has been reported to reduce the requirement for neuromuscular blocking drugs and postoperative analgesics in surgical patients. OBJECTIVE: To investigate the effect of MgSO4 on pulmonary function after video-assisted thoracoscopic surgery (VATS). DESIGN: A randomised, double-blind, placebo-controlled trial. SETTING: A university tertiary care centre...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28433839/the-diagnostic-accuracy-of-evoked-potential-monitoring-techniques-during-intracranial-aneurysm-surgery-for-predicting-postoperative-ischaemic-damage-a-systematic-review-and-meta-analysis
#3
REVIEW
Benjamin Thomas, Dongsheng Guo
OBJECTIVE: To investigate the diagnostic accuracy of various evoked potential monitoring techniques in predicting postoperative neurological deficit in intracranial aneurysm surgery. METHODS: A literature search of the MEDLINE, Embase and Cochrane databases was conducted for English language papers published between 31 March 1983 and 31 March 2016. Original studies that reported the use of evoked potential monitoring during intracranial aneurysm surgery in predicting postoperative neurological damage were selected, and their relevant reference lists were hand searched...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28386682/-update-in-neuroanesthesiology-key-publications
#4
V-S Eckle, G Schneider
One of the aims of the Scientific Working Group Neuroanesthesia (WAKNA) of the German Society of Anesthesiology and Intensive Care Medicine is to disseminate new findings in the field of neuroscience and neuroanesthesia and to propagate novel therapeutic and diagnostic options into clinical practice. Once a year, the WAKNA displays and discusses recent noteworthy publications from the past 12 months at the German Anesthesia Meeting. In 2016, a new pharmacologic strategy with dexmedetomidine to prevent postoperative pain after craniotomy, the impact of the widely used anesthetic drug propofol on GABA receptor surface expression, a study highlighting the ultrasound-guided detection of increased intracranial pressure, and an article showing the interactions of neuromuscular blocking drugs on the BIS neuromonitoring were presented...
April 6, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28367082/neuronal-effects-of-sugammadex-in-combination-with-rocuronium-or-vecuronium
#5
Martin Aldasoro, Adrian Jorda, Constanza Aldasoro, Patricia Marchio, Sol Guerra-Ojeda, Marc Gimeno-Raga, Mª Dolores Mauricio, Antonio Iradi, Elena Obrador, Jose Mª Vila, Soraya L Valles
Rocuronium (ROC) and Vecuronium (VEC) are the most currently used steroidal non-depolarizing neuromuscular blocking (MNB) agents. Sugammadex (SUG) rapidly reverses steroidal NMB agents after anaesthesia. The present study was conducted in order to evaluate neuronal effects of SUG alone and in combination with both ROC and VEC. Using MTT, CASP-3 activity and Western-blot we determined the toxicity of SUG, ROC or VEC in neurons in primary culture. SUG induces apoptosis/necrosis in neurons in primary culture and increases cytochrome C (CytC), apoptosis-inducing factor (AIF), Smac/Diablo and Caspase 3 (CASP-3) protein expression...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28366806/design-and-evaluation-of-artificial-receptors-for-the-reversal-of-neuromuscular-block
#6
Tamás Sohajda, Ákos Fábián, Kata Tuza, Milo Malanga, Gábor Benkovics, Béla Fülesdi, Edömér Tassonyi, Lajos Szente
Applying patient friendly and cost-efficient medications in healthcare will be a real challenge in the 21st century. Sugammadex is a selective, yet expensive agent used for the post-surgical reversal of neuromuscular block since 2008. A wide library of cyclodextrin-based follow-ups, having potentially similar affinity towards target aminosteroid type neuromuscular blocking agents has been established. Almost 20 compounds were assessed with respect to in vitro affinity against three commonly applied drugs. Based on the capillary electrophoretic screening, carboxymethylated and sulfobutylated gamma-cyclodextrin derivatives have the potential to be promising lead molecules for their affinity towards pipecuronium was identical or even superior to Sugammadex...
March 31, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28291680/epidemiology-of-drug-induced-anaphylaxis-in-a-tertiary-hospital-in-korea
#7
Han-Ki Park, Min-Gyu Kang, Min-Suk Yang, Jae-Woo Jung, Sang-Heon Cho, Hye-Ryun Kang
BACKGROUND: Epidemiology and risk factors of drug-induced anaphylaxis are difficult to estimate due to lack of confirmative diagnosis and under reporting. Here we report the current state of drug-induced anaphylaxis in Korea based on an in-hospital pharmacovigilance database in a tertiary hospital. METHODS: This study is a retrospective analysis of drug-induced anaphylaxis, reported to an in-hospital pharmacovigilance center in Seoul National University Hospital from June 2009 to May 2013...
March 10, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28265685/laparoscopic-partial-nephrectomy-in-a-patient-on-simvastatin-delayed-recovery-from-neuromuscular-blockade
#8
E E Abd El-Hakeem, A M Kaki, S A Almazlom, A J Alsayyad
Delayed recovery from anesthesia remains a very challenging subject for anesthesiologists. This case report describes the clinical course of delayed recovery from neuromuscular blockade after laparoscopic partial nephrectomy in a patient on simvastatin. The patient was hypertensive on regular treatment with oral captopril 25 mg twice daily and amlodipine 5 mg once daily and hypercholesterolemic on regular simvastatin 40 mg once daily with a normal electrocardiogram (ECG). All preoperative laboratory findings were within normal ranges...
March 6, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28258478/in-vitro-diagnosis-of-immediate-drug-hypersensitivity-anno-2017-potentials-and-limitations
#9
REVIEW
I I Decuyper, E A Mangodt, A L Van Gasse, K Claesen, A Uyttebroek, M Faber, V Sabato, C H Bridts, C Mertens, M M Hagendorens, L S De Clerck, Didier G Ebo
BACKGROUND: For most physicians, quantification of drug-specific immunoglobulin E (drug-sIgE) antibodies constitutes the primary in vitro measure to document immediate drug hypersensitivity reactions (IDHR). Unfortunately, this is often insufficient to correctly identify patients with IgE-mediated IDHR and impossible for non-IgE-mediated IDHR that result from alternative routes of basophil and mast cell activation. In these difficult cases, diagnosis might benefit from cellular tests such as basophil activation tests (BAT)...
March 4, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28244947/intermediate-acting-nondepolarizing-neuromuscular-blocking-agents-and-risk-of-postoperative-30-day-morbidity-and-mortality-and-long-term-survival
#10
Michael R Bronsert, William G Henderson, Terri G Monk, Joshua S Richman, Jennifer D Nguyen, John T Sum-Ping, Michael P Mangione, Binh Higley, Karl E Hammermeister
BACKGROUND: Nondepolarizing neuromuscular blocking drugs (NNMBDs) are commonly used as an adjunct to general anesthesia. Residual blockade is common, but its potential adverse effects are incompletely known. This study was designed to assess the association between NNMBD use with or without neostigmine reversal and postoperative morbidity and mortality. METHODS: This is a retrospective observational study of 11,355 adult patients undergoing general anesthesia for noncardiac surgery at 5 Veterans Health Administration (VA) hospitals...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28222701/the-effect-of-deep-muscle-relaxation-on-the-force-required-during-latissimus-dorsi-dissection-for-breast-reconstructive-surgery-results-of-a-prospective-double-blinded-observational-pilot-study
#11
T Ledowski, A Goodwin-Walters, P Quinn, M Calvert
BACKGROUND: The use of neuromuscular blocking agents has previously been suggested to facilitate the dissection of the latissimus dorsi muscle during breast reconstructive surgery. The aim of this study was to quantify the influence of deep muscle relaxation on the force required to lift the latissimus dorsi muscle during flap preparation. METHODS: After ethics approval and written informed consent 15 patients scheduled for elective breast reconstruction with a latissimus dorsi pedicled flap (muscle flap, not myocutaneous flap) under general anaesthesia were prospectively included...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28194756/chlorhexidine-allergy-in-four-specialist-allergy-centres-in-the-united-kingdom-2009-13-clinical-features-and-diagnostic-tests
#12
W Egner, M Helbert, R Sargur, K Swallow, N Harper, T Garcez, S Savic, L Savic, E Eren
We describe an observational survey of diagnostic pathways in 104 patients attending four specialist allergy clinics in the United Kingdom following perioperative hypersensitivity reactions to chlorhexidine reactions. The majority were life-threatening. Men undergoing urological or cardiothoracic surgery predominated. Skin prick testing and specific immunoglobulin (sIg)E testing were the most common tests used for diagnosis. Fifty-three per cent of diagnoses were made on the basis of a single positive test...
February 14, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28183558/frequency-of-inadequate-neuromuscular-blockade-during-general-anesthesia
#13
Timur Dubovoy, Amy M Shanks, Scott Devine, Sachin Kheterpal
STUDY OBJECTIVE: We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). DESIGN: Retrospective observational study using electronic health record data. SETTING: Operating room in a tertiary care academic hospital. PATIENTS: A total of 129,209 adult patients with American Society of Anesthesiologists physical status 1 to 5 undergoing general anesthesia in an outpatient or inpatient setting who received nondepolarizing NMB...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28178513/the-role-of-histone-deacetylase-6-in-synaptic-plasticity-and-memory
#14
Sarah Perry, Beril Kiragasi, Dion Dickman, Anandasankar Ray
Histone deacetylases (HDACs) have been extensively studied as drug targets in neurodegenerative diseases, but less is known about their role in healthy neurons. We tested zinc-dependent HDACs using RNAi in Drosophila melanogaster and found memory deficits with RPD3 and HDAC6. We demonstrate that HDAC6 is required in both the larval and adult stages for normal olfactory memory retention. Neuronal expression of HDAC6 rescued memory deficits, and we demonstrate that the N-terminal deacetylase (DAC) domain is required for this ability...
February 7, 2017: Cell Reports
https://www.readbyqxmd.com/read/28177663/hypothermia-induced-by-inhibition-of-fatty-acid-metabolism-in-anesthetized-rats-contributions-of-the-forebrain-and-vagal-afferents
#15
T Osaka
2-Mercaptoacetate (MA) is an antimetabolic drug that inhibits the utilization of fatty acids as an energy source. The intravenous injection of MA (1.2 mmol kg-1) elicited an increase in tail skin temperature and a decrease in body core temperature in urethane-chloralose-anesthetized, neuromuscularly blocked, artificially ventilated rats, though administration of the same amount of NaCl did not. The respiratory exchange ratio was significantly higher after administration of MA than that after the saline treatment...
January 29, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28164272/anaphylaxis-during-general-anaesthesia-experience-from-a-drug-allergy-centre-in-the-uk
#16
J Meng, G Rotiroti, E Burdett, J J Lukawska
BACKGROUND: Anaphylaxis during general anaesthesia is rare but often severe. Identification of the cause of anaphylaxis and recommendation of a range of drugs or agents likely to be safer for future surgery is a collaborative venture between the allergists and the anaesthesiologists, but it often poses a significant challenge. METHODS: A total of 31 patients who attended the Drug Allergy Unit at University College London Hospital with suspected perioperative anaphylaxis between March 2013 and January 2016 were reviewed retrospectively...
March 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28164269/anaesthetic-hypersensitivity-reactions-in-france-between-2011-and-2012-the-10th-gerap-epidemiologic-survey
#17
C Tacquard, O Collange, P Gomis, J-M Malinovsky, N Petitpain, P Demoly, S Nicoll, P M Mertes
BACKGROUND: Immediate hypersensitivity reactions during anaesthesia are rare but potentially life-threatening. The epidemiology changes with time and evolving professional practice, and hence needs to be monitored. Our objective was to follow this epidemiology. METHODS: This was a retrospective, observational study in French hospital clinics, conducted by GERAP members (Groupe d'Étude des Réactions Anaphylactoïdes Périopératoires). Consecutive patients seen in allergo-anaesthesia outpatient clinics, who had experienced a hypersensitivity reaction during anaesthesia between 1 January 2011 and 31 December 2012, were included...
March 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28043117/rocuronium-bromide-inhibits-inflammation-and-pain-by-suppressing-nitric-oxide-production-and-enhancing-prostaglandin-e2-synthesis-in-endothelial-cells
#18
Sang Bin Baek, Mal Soon Shin, Jin Hee Han, Sang Woong Moon, Boksoon Chang, Jung Won Jeon, Jae Woo Yi, Jun Young Chung
PURPOSE: Rocuronium bromide is a nondepolarizing neuromuscular blocking drug and has been used as an adjunct for relaxation or paralysis of the skeletal muscles, facilitation of endotracheal intubation, and improving surgical conditions during general anesthesia. However, intravenous injection of rocuronium bromide induces injection pain or withdrawal movement. The exact mechanism of rocuronium bromide-induced injection pain or withdrawal movement is not yet understood. We investigated whether rocuronium bromide treatment is involved in the induction of inflammation and pain in vascular endothelial cells...
December 2016: International Neurourology Journal
https://www.readbyqxmd.com/read/28027685/effect-of-etomidate-on-pneumonia-development-in-critically-ill-nontrauma-patients
#19
Drayton A Hammond, Claire E Vines, Ashley L McPhee, Naleen Raj Bhandari, Kendrea M Jones, Nikhil Meena, Jacob T Painter
PURPOSE: To determine whether etomidate use before intubation increased development of hospital-acquired pneumonia (HAP) in critically ill, nontrauma patients. MATERIALS AND METHODS: A single-center, retrospective, cohort study of critically ill, nontrauma patients admitted to the medical intensive care unit (ICU) from 2012 to 2015 and intubated with or without etomidate was conducted. Demographics, comorbidities, primary diagnosis, critical illness scores, concomitant medications, and outcomes were obtained from medical records...
January 1, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28008669/r-type-ca-2-channels-couple-to-inhibitory-neurotransmission-to-the-longitudinal-muscle-in-the-guinea-pig-ileum
#20
Eileen S Rodriguez-Tapia, Vinogran Naidoo, Matthew DeVries, Alberto Perez-Medina, James J Galligan
What is the central question of this study? Subtypes of enteric neurons are coded by the neurotransmitters they synthesize, but it is not known whether enteric neuron subtypes might also be coded by other proteins, including calcium channel subtypes controlling neurotransmitter release. What is the main finding and its importance? Our data indicate that guinea-pig ileum myenteric neuron subtypes may be coded by calcium channel subtypes. We found that R-type calcium channels are expressed by inhibitory but not excitatory longitudinal muscle motoneurons...
March 1, 2017: Experimental Physiology
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