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Neuromuscular monitoring

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
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
L Angius, B Pageaux, J Hopker, S M Marcora, A R Mauger
Transcranial direct current stimulation (tDCS) can increase cortical excitability of a targeted brain area, which may affect endurance exercise performance. However, optimal electrode placement for tDCS remains unclear. We tested the effect of two different tDCS electrode montages for improving exercise performance. Nine subjects underwent a control (CON), placebo (SHAM) and two different tDCS montage sessions in a randomised design. In one tDCS session, the anodal electrode was placed over the left motor cortex and the cathodal on contralateral forehead (HEAD), while for the other montage the anodal electrode was placed over the left motor cortex and cathodal electrode above the shoulder (SHOULDER)...
October 14, 2016: Neuroscience
David A Shearer, William Sparkes, Jonny Northeast, Daniel J Cunningham, Christian J Cook, Liam P Kilduff
OBJECTIVES: Biochemical (e.g. creatine kinase (CK)) and neuromuscular (e.g. peak power output (PPO)) markers of recovery are expensive and require specialist equipment. Perceptual measures are an effective alternative, yet most validated scales are too long for daily use. DESIGN: This study utilises a longitudinal multi-level design to test an adapted Brief Assessment of Mood (BAM+), with four extra items and a 100mm visual analogue scale to measure recovery. METHODS: Elite under-21 academy soccer players (N=11) were monitored across five games with data (BAM+, CK and PPO) collected for each game at 24h pre, 24h and 48h post-match...
October 5, 2016: Journal of Science and Medicine in Sport
Alladi Mohan, G Sivaram Naik, J Harikrishna, D Prabath Kumar, M H Rao, Kvs Sarma, K K Guntupalli
BACKGROUND & OBJECTIVES: Ingestion of Cleistanthus collinus causes hypokalemia and cardiac arrhythmias leading to mortality in most cases. We undertook this retrospective study to evaluate the clinical presentation and predictors of outcome in critically ill patients admitted with C. collinus poisoning. METHODS: The case records of 56 patients admitted to the medical intensive care unit (MICU) of a tertiary care teaching hospital in south India (2000-2014) with C...
June 2016: Indian Journal of Medical Research
Gregory Roe, Joshua Darrall-Jones, Kevin Till, Padraic Phibbs, Dale Read, Jonathon Weakley, Ben Jones
PURPOSE: The purpose of this study was to evaluate changes in performance of a 6-second cycle ergometer test (CET) and countermovement jump (CMJ) during a 6-week training block in professional rugby union players. METHODS: Twelve young professional rugby union players performed two CET and CMJ on the first and fourth morning of every week prior to the commencement of daily training during a 6-week training block. Standardised changes in the highest score of two CET and CMJ efforts were assessed using linear mixed modelling and magnitude-based inferences...
October 13, 2016: International Journal of Sports Physiology and Performance
Y Rogozhina, S Mironovich, A Shestak, T Adyan, A Polyakov, D Podolyak, A Bakulina, S Dzemeshkevich, E Zaklyazminskaya
BACKGROUND: Most of mutations in the LMNA gene are unique and have been found in only a few unrelated families. The clinical interpretation of new genetic variants, especially beyond the coding area and canonical splice sites, is proving to be difficult and requires advanced investigation. METHODS: This study included patients with progressive cardiac conduction defects with neuromuscular involvement. The clinical evaluation included medical history and 24-h Holter monitoring...
October 4, 2016: Gene
Sebastián Figueroa-Bonaparte, Sonia Segovia, Jaume Llauger, Izaskun Belmonte, Irene Pedrosa, Aída Alejaldre, Mercè Mayos, Guillermo Suárez-Cuartín, Eduard Gallardo, Isabel Illa, Jordi Díaz-Manera
OBJECTIVES: Enzyme replacement therapy has shown to be effective for childhood/adult onset Pompe disease (AOPD). The discovery of biomarkers useful for monitoring disease progression is one of the priority research topics in Pompe disease. Muscle MRI could be one possible test but the correlation between muscle MRI and muscle strength and function has been only partially addressed so far. METHODS: We studied 34 AOPD patients using functional scales (Manual Research Council scale, hand held myometry, 6 minutes walking test, timed to up and go test, time to climb up and down 4 steps, time to walk 10 meters and Motor Function Measure 20 Scale), respiratory tests (Forced Vital Capacity seated and lying, Maximun Inspiratory Pressure and Maximum Expiratory Pressure), daily live activities scales (Activlim) and quality of life scales (Short Form-36 and Individualized Neuromuscular Quality of Life questionnaire)...
2016: PloS One
Annelijn M Meeder, Marijke S van der Steen, Annemieke Rozendaal, Arthur R H van Zanten
This case report series describes 3 cases of cisatracurium besylate associated phlebitis after an infusion period of 14-20 hours. No similar cases have been reported in the literature. Association of phlebitis with another neuromuscular blocking agent, atracurium, has been described in the literature. The acidity of atracurium is thought to be the main cause. It is recommended that atracurium is administered only via central venous catheters when indicated to infuse over prolonged periods of time due to the acidity...
October 3, 2016: BMJ Case Reports
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
C L Errando-Oyonarte, C Moreno-Sanz, P Vila-Caral, J C Ruiz de Adana-Belbel, E Vázquez-Alonso, J M Ramírez-Rodríguez, G Veiga-Ruiz, E Guasch-Arévalo, J I Lora-Tamayo D'Ocón
INTRODUCTION: Neuromuscular blockade enables airway management, ventilation and surgical procedures. However there is no national consensus on its routine clinical use. The objective was to establish the degree of agreement among anaesthesiologists and general surgeons on the clinical use of neuromuscular blockade in order to make recommendations to improve its use during surgical procedures. METHODS: Multidisciplinary consensus study in Spain. Anaesthesiologists experts in neuromuscular blockade management (n=65) and general surgeons (n=36) were included...
September 28, 2016: Revista Española de Anestesiología y Reanimación
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
Gita M Ramdharry, Alexander J Pollard, Robert Grant, Elizabeth L Dewar, Matilde Laurá, Sarah A Moore, Kate Hallsworth, Thomas Ploetz, Michael I Trenell, Mary M Reilly
PURPOSE: Charcot Marie Tooth disease (CMT) describes a group of hereditary neuropathies that present with distal weakness, wasting and sensory loss. Small studies indicate that people with CMT have reduced daily activity levels. This raises concerns as physical inactivity increases the risk of a range of co- morbidities, an important consideration in the long-term management of this disease. This study aimed to compare physical activity, patterns of sedentary behavior and overall energy expenditure of people with CMT and healthy matched controls...
August 16, 2016: Disability and Rehabilitation
Amilton Vieira, Angelina F Siqueira, João B Ferreira-Junior, Paulo Pereira, Dale Wagner, Martim Bottaro
Background: Different ultrasound parameters have been frequently used to assess changes associated with training, aging, immobilization, and neuromuscular diseases. However, an exploratory reliability analysis of the echo intensity (EI) and muscle thickness (MT) of the forearm flexors is scarce, especially in women. Objective: The purpose of the present study was to determine the intra-rater reliability of MT and EI assessed by ultrasound in young women. Method: Ultrasonographic MT and EI were acquired in the forearm flexors of 41 young women (22±2 yrs)...
September 15, 2016: Brazilian Journal of Physical Therapy
Adam Ogna, Julie Nardi, Helene Prigent, Maria-Antonia Quera Salva, Cendrine Chaffaut, Laure Lamothe, Sylvie Chevret, Djillali Annane, David Orlikowski, Frederic Lofaso
BACKGROUND: Restrictive respiratory failure is a major cause of morbidity and mortality in neuromuscular diseases (NMD). Home mechanical ventilation (HMV) is used to treat hypoventilation, and its efficiency is mostly assessed by daytime blood gases or nocturnal oxygen saturation monitoring (SpO2). Non-invasive transcutaneous measure of CO2 (TcCO2) allows to directly assess nocturnal hypercapnia and to detect residual hypoventilation with a higher sensitivity than SpO2. We aimed to compare the prognostic value of nocturnal SpO2 and TcCO2 in ventilated adult NMD patients...
2016: Frontiers in Medicine
João Gustavo Claudino, John Cronin, Bruno Mezêncio, Daniel Travis McMaster, Michael McGuigan, Valmor Tricoli, Alberto Carlos Amadio, Julio Cerca Serrão
OBJECTIVES: The primary objective of this meta-analysis was to compare countermovement jump (CMJ) performance in studies that reported the highest value as opposed to average value for the purposes of monitoring neuromuscular status (i.e., fatigue and supercompensation). The secondary aim was to determine the sensitivity of the dependent variables. DESIGN: Systematic review with meta-analysis. METHODS: The meta-analysis was conducted on the highest or average of a number of CMJ variables...
August 25, 2016: Journal of Science and Medicine in Sport
Divya Anand, Babita Pandey, Devendra K Pandey
An accurate classification of neuromuscular disorders is important in providing proper treatment facilities to the patients. Recently, the microarray technology is employed to monitor the level of activity or expression of large number of genes simultaneously. The gene expression data derived from the microarray experiment usually involve a large number of genes but a very few number of samples. There is a need to reduce the dimension of gene expression data which intends to find a small set of discriminative genes that accurately classifies the samples of various kinds of diseases...
September 17, 2016: Interdisciplinary Sciences, Computational Life Sciences
Lachlan P James, Emma M Beckman, Vincent G Kelly, G Gregory Haff
PURPOSE: To determine whether the maximal strength, impulse and power characteristics of competitive mixed martial arts (MMA) athletes differ according to competition level. METHODS: Twenty-nine male semi-professional and amateur MMA competitors were stratified into either higher-level (HL) or lower-level (LL) performers on the basis of competition grade and success. The one-repetition maximum (1RM) squat was used to assess lower body dynamic strength, while a spectrum of impulse, power, force and velocity variables were evaluated during an incremental load jump squat...
September 15, 2016: International Journal of Sports Physiology and Performance
Anil Karlekar, Devesh Dutta, Ravindra Saxena, Krishna Kant Sharma
Myasthenia gravis (MG) is a rare disorder involving neuromuscular junction. In conjunction with medical therapy, thymectomy is a known modality of treatment of MG and has shown to increase the probability of remission and overall symptomatic improvement. For minimally invasive thymectomy, video-.assisted thoracoscopic surgery has been the preferred surgical approach till recently. The robotic surgical procedure must necessarily bring new challenges to the anesthesiologists to effectively meet the specific requirements of the technique...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Fernando Pareja-Blanco, Luis Sánchez-Medina, Luis Suárez-Arrones, Juan José González-Badillo
AIM: To analyze the effects of two resistance training (RT) programs that used the same relative loading but different repetition volume, using the velocity loss during the set as the independent variable: 15% (VL15) vs. 30% (VL30). METHODS: Sixteen professional soccer players with RT experience (age 23.8 ± 3.5 years, body mass 75.5 ± 8.6 kg) were randomly assigned to two groups: VL15 (n = 8) or VL30 (n = 8) that followed a 6-week (18 sessions) velocity-based squat training program...
September 6, 2016: International Journal of Sports Physiology and Performance
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