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Neuromuscular block

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https://www.readbyqxmd.com/read/28062917/the-enteric-nervous-system-and-the-musculature-of-the-colon-are-altered-in-patients-with-spina-bifida-and-spinal-cord-injury
#1
Marjanne den Braber-Ymker, Martin Lammens, Michel J A M van Putten, Iris D Nagtegaal
Neurogenic bowel dysfunction occurs in a large percentage of adult patients with spina bifida (SB) and spinal cord injury (SCI), significantly affecting their quality of life. Although bowel motility is autonomously regulated by the enteric nervous system (ENS), disruption of the modulation of the ENS by extrinsic innervation as present in many patients with SB and SCI might lead to motility disorders. In order to gain insight in the pathophysiology, we studied histological changes of the neuromuscular structures in the colon of SB and SCI patients...
January 6, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28049438/important-modifications-by-sugammadex-a-modified-%C3%AE-cyclodextrin-of-ion-currents-in-differentiated-nsc-34-neuronal-cells
#2
Hung-Te Hsu, Yi-Ching Lo, Yan-Ming Huang, Yu-Ting Tseng, Sheng-Nan Wu
BACKGROUND: Sugammadex (SGX) is a modified γ-cyclodextrin used for reversal of steroidal neuromuscular blocking agents during general anesthesia. Despite its application in clinical use, whether SGX treatment exerts any effects on membrane ion currents in neurons remains largely unclear. In this study, effects of SGX treatment on ion currents, particularly on delayed-rectifier K(+) current [I K(DR)], were extensively investigated in differentiated NSC-34 neuronal cells. RESULTS: After cells were exposed to SGX (30 μM), there was a reduction in the amplitude of I K(DR) followed by an apparent slowing in current activation in response to membrane depolarization...
January 3, 2017: BMC Neuroscience
https://www.readbyqxmd.com/read/28044330/conceptual-and-technical-insights-into-the-basis-of-neuromuscular-monitoring
#3
REVIEW
M Naguib, S J Brull, K B Johnson
Unrecognised postoperative residual neuromuscular block remains a frequent occurrence in recovery rooms. Evidence indicates that current practice continues to perpetuate the status quo, in which 10-40% of patients experience postoperative residual weakness. A departure from the current practice requires small efforts on the clinicians' part. This review addresses several selected core questions regarding neuromuscular blockade monitoring and provides a framework to rationally discuss and develop basic guidelines for the use of neuromuscular blocking agents in patient care...
January 2017: Anaesthesia
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
#4
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/28030444/impact-of-reversal-strategies-on-the-incidence-of-postoperative-residual-paralysis-after-rocuronium-relaxation-without-neuromuscular-monitoring-a-partially-randomised-placebo-controlled-trial
#5
Réka Nemes, Béla Fülesdi, Adrienn Pongrácz, László Asztalos, Zoltán Szabó-Maák, Szabolcs Lengyel, Edömér Tassonyi
BACKGROUND: Electronic neuromuscular monitoring is not widely used to determine either the reversal requirements for neuromuscular block before extubation of the trachea, or to determine if there is any subsequent postoperative residual neuromuscular block (PORNB). OBJECTIVES: To investigate the incidence of PORNB using acceleromyography after spontaneous recovery of rocuronium-induced block and to compare this with the administration of sugammadex, neostigmine or a placebo...
December 26, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28027685/effect-of-etomidate-on-pneumonia-development-in-critically-ill-nontrauma-patients
#6
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/28013329/effects-of-neuromuscular-blockers-on-transpulmonary-pressures-in-moderate-to-severe-acute-respiratory-distress-syndrome
#7
Christophe Guervilly, Magali Bisbal, Jean Marie Forel, Malika Mechati, Samuel Lehingue, Jeremy Bourenne, Gilles Perrin, Romain Rambaud, Melanie Adda, Sami Hraiech, Elisa Marchi, Antoine Roch, Marc Gainnier, Laurent Papazian
PURPOSE: To investigate whether neuromuscular blocking agents (NMBA) exert beneficial effects in acute respiratory distress syndrome (ARDS) by reason of their action on respiratory mechanics, particularly transpulmonary pressures (P L). METHODS: A prospective randomised controlled study in patients with moderate to severe ARDS within 48 h of the onset of ARDS. All patients were monitored by means of an oesophageal catheter and followed up for 48 h. Moderate ARDS patients were randomised into two groups according to whether they were given a 48-h continuous infusion of cisatracurium besylate or not (control group)...
December 24, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/28012426/perceived-safety-and-efficacy-of-neuromuscular-blockers-for-acute-respiratory-distress-syndrome-among-medical-intensive-care-unit-practitioners-a-multicenter-survey
#8
Heather Torbic, Seth R Bauer, Heather A Personett, Amy L Dzierba, Joanna L Stollings, Lindsay P Ryder, Craig E Daniels, Sean M Caples, Erin N Frazee
PURPOSE: Neuromuscular blocking agents (NMBAs) are frequently used in patients with acute respiratory distress syndrome (ARDS). The purpose of this survey is to describe providers' knowledge and perceived efficacy and safety of NMBAs in patients with ARDS. MATERIALS AND METHODS: We performed a prospective, multicenter survey of medical intensive care unit intensivists, fellows, nurse practitioners (NPs), physician's assistants (PAs), and pharmacists at 5 tertiary care centers between July 2012 and May 2013...
December 7, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28008669/r-type-ca-2-channels-couple-to-inhibitory-neurotransmission-to-the-longitudinal-muscle-in-the-guinea-pig-ileum
#9
Eileen S Rodriguez-Tapia, Vinogran Naidoo, Matthew DeVries, Alberto Perez-Medina, James J Galligan
There is evidence that R-type Ca(2+) channels contribute to synaptic transmission in the myenteric plexus. It is unknown if R-type Ca(2+) channels contribute to neuromuscular transmission. We measured the effects of the nitric oxide synthase (NOS) inhibitor, nitro L-arginine (NLA), Ca(2+) channel blockers and apamin (SK channel blocker) on neurogenic relaxations and contractions of the guinea pig ileum longitudinal muscle-myenteric plexus (LMMP) in vitro. We used intracellular recordings to measure inhibitory junction potentials (IJPs)...
December 23, 2016: Experimental Physiology
https://www.readbyqxmd.com/read/27999389/transcriptome-analysis-to-understand-the-toxicity-of-latrodectus-tredecimguttatus-eggs
#10
Dehong Xu, Xianchun Wang
Latrodectus tredecimguttatus is a kind of highly venomous black widow spider, with toxicity coming from not only venomous glands but also other parts of its body as well as newborn spiderlings and eggs. Up to date, although L. tredecimguttatus eggs have been demonstrated to be rich in proteinaceous toxins, there is no systematic investigation on such active components at transcriptome level. In this study, we performed a high-throughput transcriptome sequencing of L. tredecimguttatus eggs with Illumina sequencing technology...
December 20, 2016: Toxins
https://www.readbyqxmd.com/read/27990107/a-novel-striated-muscle-specific-myosin-blocking-drug-for-the-study-of-neuromuscular-physiology
#11
Dante J Heredia, Douglas Schubert, Siddhardha Maligireddy, Grant W Hennig, Thomas W Gould
The failure to transmit neural action potentials (APs) into muscle APs is referred to as neuromuscular transmission failure (NTF). Although synaptic dysfunction occurs in a variety of neuromuscular diseases and impaired neurotransmission contributes to muscle fatigue, direct evaluation of neurotransmission by measurement of successfully transduced muscle APs is difficult due to the subsequent movements produced by muscle. Moreover, the voltage-gated sodium channel inhibitor used to study neurotransmitter release at the adult neuromuscular junction is ineffective in embryonic tissue, making it nearly impossible to precisely measure any aspect of neurotransmission in embryonic lethal mouse mutants...
2016: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/27967250/bitopic-muscarinic-agonists-and-antagonists-and-uses-thereof-a-patent-evaluation-of-us20160136145a1
#12
Ulrike Holzgrabe, Michael Decker
Bitopic M ligands, that is, ligands that interact both with the ortho- and allosteric binding sites of the M receptor subtypes, hold great potential as novel selective for muscarinic acetylcholine (M) ligands for several therapeutic applications. Areas covered: The patent application describes a set of compounds based on the neurotransmitter acetylcholine applying the Schulman-model for M ligands comprising heterocyclic (often quaternary) amines and a benzene ring (often as benzoic acid esters) to act as bitopic ligands...
December 26, 2016: Expert Opinion on Therapeutic Patents
https://www.readbyqxmd.com/read/27964993/laminin-is-instructive-and-calmodulin-dependent-kinase-ii-is-non-permissive-for-the-formation-of-complex-aggregates-of-acetylcholine-receptors-on-myotubes-in-culture
#13
Raphael Vezina-Audette, Mathieu Tremblay, Salvatore Carbonetto
Previous work has shown that myotubes cultured on laminin-coated substrates form complex aggregates of synaptic proteins that are similar in shape and composition to neuromuscular junctions (NMJs). Here we show that laminin instructs the location of complex aggregates which form only on the lower surface when laminin is coated onto culture dishes but over the entire cell when laminin is added in solution. Silencing of myotubes by agents that block electrical activity (tetrodotoxin, verapamil) or by inhibitors of calmodulin dependent kinase (CaMKII) render the myotube permissive for the formation of complex aggregates...
December 10, 2016: Matrix Biology: Journal of the International Society for Matrix Biology
https://www.readbyqxmd.com/read/27955984/lower-extremity-weakness-in-a-teenager-due-to-thyrotoxic-periodic-paralysis
#14
Matthew D Thornton
BACKGROUND: Thyrotoxic hypokalemic paralysis is the hallmark of thyrotoxic periodic paralysis (TPP). TPP is a potentially deadly complication of hyperthyroidism that occurs because of rapid and dramatic intracellular shift of potassium. This transference results in severe hypokalemia and clinically manifests itself as muscle weakness or paralysis. This condition predominantly affects males of Asian descent, and its presentation can range from mild to severe, as seen in our case. CASE REPORT: We present the case of a 15-year-old Asian-American male who presented to a tertiary-care pediatric emergency department complaining of generalized weakness and flaccid paralysis of his lower extremities...
December 9, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27936214/deep-neuromuscular-block-improves-surgical-conditions-during-bariatric-surgery-and-reduces-postoperative-pain-a-randomized-double-blind-controlled-trial
#15
Bart Torensma, Chris H Martini, Martijn Boon, Erik Olofsen, Bas In 't Veld, Ronald S L Liem, Mireille T T Knook, Dingeman J Swank, Albert Dahan
BACKGROUND: It remains unknown whether the administration of a deep neuromuscular block (NMB) during bariatric surgery improves surgical conditions and patient outcome. The authors studied the effect of deep versus moderate NMB in laparoscopic bariatric surgery on surgical conditions and postoperative pain. METHODS AND RESULTS: One hundred patients scheduled to undergo elective bariatric surgery were randomized to a deep NMB (post-tetanic-count 2-3) or a moderate NMB (train-of-four 1-2)...
2016: PloS One
https://www.readbyqxmd.com/read/27922561/a-pharmacologic-review-of-anaphylaxis
#16
Nancy S Yunker, Bradley J Wagner
Anaphylaxis occurs in the surgical population and may have devastating consequences. Anaphylaxis and anaphylactoid reactions are immediate hypersensitivity reactions that are most commonly precipitated by medications, insect stings, and foods. In the surgical population, 47.4% of immediate hypersensitivity reactions were precipitated by neuromuscular blocking agents, followed by latex and antibiotics in 20% and 18.1% of cases, respectively. Initial treatment consists of removing the precipitating trigger, administering epinephrine, and correct patient positioning...
October 2016: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/27916456/acute-fasting-regulates-retrograde-synaptic-enhancement-through-a-4e-bp-dependent-mechanism
#17
Grant Kauwe, Kazuya Tsurudome, Jay Penney, Megumi Mori, Lindsay Gray, Mario R Calderon, Fatima Elazouzzi, Nicole Chicoine, Nahum Sonenberg, A Pejmun Haghighi
While beneficial effects of fasting on organismal function and health are well appreciated, we know little about the molecular details of how fasting influences synaptic function and plasticity. Our genetic and electrophysiological experiments demonstrate that acute fasting blocks retrograde synaptic enhancement that is normally triggered as a result of reduction in postsynaptic receptor function at the Drosophila larval neuromuscular junction (NMJ). This negative regulation critically depends on transcriptional enhancement of eukaryotic initiation factor 4E binding protein (4E-BP) under the control of the transcription factor Forkhead box O (Foxo)...
December 21, 2016: Neuron
https://www.readbyqxmd.com/read/27909595/effect-of-smoking-on-reversing-neuromuscular-block
#18
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
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
#19
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/27886889/update-on-ocular-myasthenia-gravis
#20
REVIEW
Stacy V Smith, Andrew G Lee
Ocular myasthenia gravis (OMG) is a localized form of myasthenia gravis in which autoantibodies directed against acetylcholine receptors block or destroy these receptors at the postsynaptic neuromuscular junction. The hallmark of OMG is a history of painless weakness or fatigability of the extraocular muscles and ptosis with normal pupillary function and visual acuity. Clinical, laboratory, electrophysiologic, and pharmacologic tests are available for diagnosis. Treatment can begin with symptom management; there is no cure...
February 2017: Neurologic Clinics
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