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Neuromuscular block

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https://www.readbyqxmd.com/read/27909595/effect-of-smoking-on-reversing-neuromuscular-block
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/27882347/ml372-blocks-smn-ubiquitination-and-improves-spinal-muscular-atrophy-pathology-in-mice
#4
Mahlet B Abera, Jingbo Xiao, Jonathan Nofziger, Steve Titus, Noel Southall, Wei Zheng, Kasey E Moritz, Marc Ferrer, Jonathan J Cherry, Elliot J Androphy, Amy Wang, Xin Xu, Christopher Austin, Kenneth H Fischbeck, Juan J Marugan, Barrington G Burnett
Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease and one of the leading inherited causes of infant mortality. SMA results from insufficient levels of the survival motor neuron (SMN) protein, and studies in animal models of the disease have shown that increasing SMN protein levels ameliorates the disease phenotype. Our group previously identified and optimized a new series of small molecules, with good potency and toxicity profiles and reasonable pharmacokinetics, that were able to increase SMN protein levels in SMA patient-derived cells...
November 17, 2016: JCI Insight
https://www.readbyqxmd.com/read/27872771/tranexamic-acid-an-exceedingly-rare-cause-of-anaphylaxis-during-anaesthesia
#5
R A Bansal, A Nicholas, A S Bansal
Tranexamic acid (TXA) allergy is extremely rare. An 80-year-old woman without prior exposure to TXA underwent elective knee replacement. Shortly after induction of anaesthesia and intravenous TXA, she developed hypotension, tachycardia, and facial erythema accompanied by a raised serum tryptase. Later, skin prick and intradermal testing confirmed positive responses to TXA in high dilution and with negative results to the other drugs used. While neuromuscular blocking agents, opiates, and antibiotics remain the most frequent cause of anaphylaxis during anaesthesia, allergy to TXA should always be borne in mind and requires skin testing for confirmation as there are presently no blood tests available...
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/27871583/sugammadex-given-for-rocuronium-induced-neuromuscular-blockade-in-infants-a-retrospect%C3%A4-ve-study
#6
Ozlem Ozmete, Cagla Bali, Oya Yalcin Cok, Hatice Evren Eker Turk, Nesrın Bozdogan Ozyilkan, Soner Civi, Anıs Aribogan
STUDY OBJECTIVE: To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients. DESIGN: Retrospective observational study. SETTING: University teaching hospital. PATIENTS: Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study...
December 2016: Journal of Clinical Anesthesia
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
#7
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
#8
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/27859358/six-years-without-pholcodine-norwegians-are-significantly-less-ige-sensitized-and-clinically-more-tolerant-to-neuromuscular-blocking-agents
#9
G H de Pater, E Florvaag, S G O Johansson, Å Irgens, M N H Petersen, A B Guttormsen
BACKGROUND: As a strong inducer of IgE-antibodies to substituted ammonium ion epitopes (QAI), pholcodine (PHO) is a postulated cause of allergic anaphylaxis to neuromuscular blocking agents (NMBAs). Three years after withdrawal of PHO in Norway, a significant reduction in IgE-sensitization and anaphylaxis reporting was seen. OBJECTIVE: Six year follow-up study on the effects of PHO withdrawal on IgE-sensitization and anaphylaxis reporting. METHODS: From 650 acute consecutive reports (2005-2013) to the Norwegian Network for Anaphylaxis under Anaesthesia (NARA), total number of reports on suspected anaphylactic reactions, number of reactions where NMBAs were administered, number of reactions where serum IgE-antibodies (≥0...
November 9, 2016: Allergy
https://www.readbyqxmd.com/read/27855736/glutamate-is-a-wake-active-neurotransmitter-in-drosophila-melanogaster
#10
John E Zimmerman, May T Chan, Olivia T Lenz, Brendan T Keenan, Greg Maislin, Allan I Pack
STUDY OBJECTIVES: In mammals, there is evidence that glutamate has a role as a wake active neurotransmitter. So using video-based analysis of Drosophila behavior we undertook a study to examine if glutamate, which has been previously shown to have an excitatory role in neuromuscular junctions in Drosophila, may have a conserved wake-active role in the adult brain. METHODS: Using 6-9 day old female flies we examined the effect of perturbations of the glutamatergic signaling on total wakefulness and wake bout architecture...
October 28, 2016: Sleep
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
#11
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/27850841/1205-evaluation-of-a-neuromuscular-blocking-agent-order-set-in-the-intensive-care-unit
#12
Chelsea Tasaka, Kendall Gross, Ashley Thompson, Deanna Horner, Cindy Burg, John Turnbull, Matthew Aldrich, Fanny Li
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27847404/neuroprotective-effects-of-bone-marrow-mesenchymal-stem-cells-on-bilateral-common-carotid-arteries-occlusion-model-of-cerebral-ischemia-in-rat
#13
Bagher Pourheydar, Sara Soleimani Asl, Mostafa Azimzadeh, Adel Rezaei Moghadam, Asghar Marzban, Mehdi Mehdizadeh
Cell therapy is the most advanced treatment of the cerebral ischemia, nowadays. Herein, we discuss the neuroprotective effects of bone marrow mesenchymal stem cells (BMSCs) on rat hippocampal cells following intravenous injection of these cells in an ischemia-reperfusion model. Adult male Wistar rats were divided into 5 groups: control, sham (surgery without blockage of common carotid arteries), ischemia (common carotid arteries were blocked for 30 min prior to reperfusion), vehicle (7 days after ischemia PBS was injected via the tail vein), and treatment (injections of BMSC into the tail veins 7 days after ischemia)...
2016: Behavioural Neurology
https://www.readbyqxmd.com/read/27832572/the-influence-of-introducing-unrestricted-access-to-sugammadex-and-quantitative-neuromuscular-monitors-on-the-incidence-of-residual-neuromuscular-block-at-a-tertiary-teaching-hospital-an-audit-of-real-life
#14
J I Milne, C S Ong, J S Ong, K C Cheung, A A Schauer, S B Buttar, T Ledowski
No abstract text is available yet for this article.
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27828786/the-effect-of-prior-tetanic-stimulation-on-train-of-four-monitoring-in-paediatric-patients-a-randomised-open-label-controlled-trial
#15
Ricardo V Carlos, Hans Donald de Boer, Marcelo Luis Abramides Torres, Maria José Carvalho Carmona
BACKGROUND: In clinical research, neuromuscular monitoring must present a stable response for a period of 2 to 5 min before administration of a neuromuscular blocking agent. The time required to reach this stable response may be shortened by applying a 5-s tetanic stimulus. OBJECTIVES: The aim of this study was to test whether tetanic stimulation interferes with onset and recovery times after a single dose of rocuronium 0.6 mg kg followed by spontaneous recovery...
November 8, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27820709/current-status-of-neuromuscular-reversal-and-monitoring-challenges-and-opportunities
#16
Sorin J Brull, Aaron F Kopman
Postoperative residual neuromuscular block has been recognized as a potential problem for decades, and it remains so today. Traditional pharmacologic antagonists (anticholinesterases) are ineffective in reversing profound and deep levels of neuromuscular block; at the opposite end of the recovery curve close to full recovery, anticholinesterases may induce paradoxical muscle weakness. The new selective relaxant-binding agent sugammadex can reverse any depth of block from aminosteroid (but not benzylisoquinolinium) relaxants; however, the effective dose to be administered should be chosen based on objective monitoring of the depth of neuromuscular block...
November 7, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27818334/neuromuscular-blockade-in-the-21-st-century-management-of-the-critically-ill-patient
#17
REVIEW
Julian deBacker, Nicholas Hart, Eddy Fan
Neuromuscular blockings agents (NMBAs) have a controversial role in the ventilatory and medical management of critical illness. The clinical concern surrounding NMBA-induced complications stems from evidence presented in the 2002 clinical practice guidelines, but new evidence from subsequent randomized trials and studies provides a more optimistic outlook about the application of NMBAs in the intensive care unit (ICU). Furthermore, changes in the delivery of critical care such as protocolized care pathways, minimizing or interrupting sedation, increased monitoring techniques, and overall improvements in reducing immobility have created a modern, 21st century ICU environment whereby NMBAs may be administered safely...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27798767/practical-management-of-anaesthesia-in-the-elderly
#18
Camilla Strøm, Lars Simon Rasmussen, Jacob Steinmetz
The elderly population is rapidly growing and particularly diverse. Ageing leads to reduced organ function and a decline in physiologic reserve. Elderly patients are characterised by great inter-individual variability in physiological function with a high prevalence of chronic disease. In general, older patients have a higher risk of postoperative adverse outcomes, and frailty is a very important risk factor. This review article aims to provide a practical guide to anaesthetic management of the elderly surgical patient...
October 31, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27797097/neuromuscular-blockade-in-the-elderly
#19
Michał Stankiewicz-Rudnicki
The aim of the presented review is to highlight the clinical problem of postoperative residual curarization (PORC) following general anaesthesia in the elderly. Possible complications of PORC are described along with age-induced changes in pharmacokinetics of long and intermediate-acting neuromuscular blocking agents. This is intended to facilitate the selection and to promote appropriate intraoperative use of muscle relaxants in patients over the age of 65 years.
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27796041/optimal-anesthetic-regimen-for-ambulatory-laser-microlaryngeal-surgery
#20
Hyub Huh, Seol Ju Park, Hyong Hwan Lim, Kwang Yoon Jung, Seung-Kuk Baek, Seung Zhoo Yoon, Hye Won Lee, Hye Ja Lim, Jang Eun Cho
OBJECTIVES/HYPOTHESIS: Laser microlaryngeal surgery (LMS) is a short operation requiring brief and intense paralysis. Adequate muscle relaxation and rapid recovery of neuromuscular function are essential for improving surgical conditions and reducing the incidence of complications during LMS. However, the ideal muscle relaxant with a rapid onset and short duration of action is not yet available. Rocuronium has rapid onset at higher doses, but with a prolonged duration of action. Sugammadex is a selective relaxant-binding agent that allows for rapid reversal of rocuronium-induced neuromuscular blockade...
October 31, 2016: Laryngoscope
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