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https://www.readbyqxmd.com/read/29756064/neuromuscular-monitoring-an-update
#1
REVIEW
Mădălina Duţu, Robert Ivaşcu, Oana Tudorache, Darius Morlova, Alina Stanca, Silvius Negoiţă, Dan Corneci
This review makes an advocacy for neuromuscular blockade monitoring during anaesthesia care, by: (i) describing the fundamental principles of the methods currently available, at the same time emphasizing quantitative recording measurements; (ii) describing the different ways in which muscles respond to the effect of neuromuscular blockade and their use in clinical practice; (iii) presenting results of different studies on timing and agents of neuromuscular block reversal, including a recommendation for sugammadex use and experimental results with calabadion and (iv) in the end emphasizing the need for implementing neuromuscular monitoring as a practice that should be used every time a neuromuscular block is required...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29752664/patient-related-factors-predicting-workspace-conditions-during-laparoscopic-bariatric-surgery
#2
Paola Aceto, Cristina Modesti, Teresa Sacco, Roberto De Cicco, Valter Perilli, Marco Raffaelli, Carlo Lai, Liliana Sollazzi
BACKGROUND: Previous studies have focused on the role of deep neuromuscular blockade (NMB) in improving surgical conditions during laparoscopic bariatric surgery. However, a wide inter-individual variability has been noted. The aim of this study was to identify patient-related factors affecting surgeon satisfaction with the surgical space and surgery duration in laparoscopic bariatric surgery under deep NMB. METHODS: One hundred eighty-five patients scheduled for laparoscopic gastric bypass were enrolled...
May 12, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29727028/effects-of-depth-of-neuromuscular-block-on-surgical-conditions-during-laparoscopic-colorectal-surgery-a-randomised-controlled-trial
#3
B W Koo, A Y Oh, H S Na, H J Lee, S B Kang, D W Kim, K S Seo
There have been few objective evaluations of the effects of deep neuromuscular blockade on intra-operative conditions. In this prospective randomised controlled study, we evaluated the effects of deep neuromuscular block on surgical conditions during laparoscopic colorectal surgery. Patients were randomly allocated using a computer-generated randomisation code to either moderate (train-of-four count 1-2 maintained and antagonised with neostigmine) or deep (post-tetanic count 1-2 maintained and reversed with sugammadex) levels of neuromuscular blockade...
May 4, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29727011/postoperative-laryngeal-morbidity-and-intubating-conditions-using-the-mcgrath%C3%A2-mac-videolaryngoscope-with-or-without-neuromuscular-blockade-a-randomised-double-blind-non-inferiority-trial
#4
T Nakanishi, M Yoshimura, S Sakamoto, T Toriumi
Tracheal intubation without neuromuscular blockade may be associated with worse intubating conditions and increased laryngeal morbidity. We hypothesised that tracheal intubation using the McGRATH™ MAC videolaryngoscope would not increase postoperative hoarseness, even without neuromuscular blockade. In this prospective, randomised, parallel-group, double-blind, non-inferiority trial, 248 patients were randomly assigned to tracheal intubation with or without neuromuscular blockade using rocuronium. Hoarseness and sore throat were evaluated at 24 h and 48 h postoperatively...
May 4, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29724584/stereotactic-body-radiation-therapy-for-heart-base-tumors-in-six-dogs
#5
L M Magestro, T L Gieger, M W Nolan
INTRODUCTION: Heart-base tumors are increasingly treated with radiotherapy, yet safety and efficacy are incompletely understood. This case series describes outcomes after stereotactic body radiation therapy (SBRT) for presumed chemodectoma. ANIMALS: Six pet dogs. METHODS: A retrospective study was performed, including dogs with a clinical diagnosis of chemodectoma and treatment with three-fraction SBRT (30 Gy total). RESULTS: Heart-base tumors, presumed or confirmed to be chemodectomas, were diagnosed via histopathology or imaging...
April 30, 2018: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/29706811/use-of-neuromuscular-blocking-agents-in-acute-respiratory-distress-syndrome
#6
REVIEW
G Tsai-Nguyen, Ariel M Modrykamien
Acute respiratory distress syndrome is the result of an acute inflammatory response of the lungs, causing severe hypoxemia. A variety of therapeutic modalities have been extensively studied, with only a few demonstrating improvement in survival. Specifically, mechanical ventilation with use of low tidal volumes, prone positioning, and treatment with neuromuscular blocking agents have proven beneficial. This article focuses on the utilization of neuromuscular blocking agents in this entity. In particular, we briefly review the mechanism of action of neuromuscular blockades, the latest published evidence supporting their use in acute respiratory distress syndrome, and current recommendations for their utilization in clinical practice...
April 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29692886/what-are-the-optimum-components-in-a-care-bundle-aimed-at-reducing-post-operative-pulmonary-complications-in-high-risk-patients
#7
Sophie V Griffiths, Daniel H Conway, Michael Sander, Ib Jammer, Michael P W Grocott, Ben C Creagh-Brown
Background: Post-operative pulmonary complications (POPC) are common, predictable and associated with increased morbidity and mortality, independent of pre-operative risk. Interventions to reduce the incidence of POPC have been studied individually, but the use of a care bundle has not been widely investigated. The purpose of our work was to use Delphi consensus methodology and an independently chosen expert panel to formulate a care bundle for patients identified as being at high of POPC, as preparation towards an evaluation of its effectiveness at reducing POPC...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29690754/effects-of-adenosine-receptor-agonist-on-the-rocuroniuminduced-neuromuscular-block-and-sugammadex-induced-recovery
#8
Yong Beom Kim, Sangseok Lee, Hey Ran Choi, Junyong In, Young Jin Chang, Ha Jung Kim, Young Jin Ro, Hong-Seuk Yang
Background: Several types of receptors are found at neuromuscular presynaptic membranes. Presynaptic inhibitory A1 and facilitatory A2A receptors mediate different modulatory functions on acetylcholine release. This study investigated whether adenosine A1 receptor agonist contributes to the first twitch tension (T1) of train-of-four (TOF) stimulation depression and TOF fade during rocuronium-induced neuromuscular blockade, and sugammadex-induced recovery. Methods: Phrenic nerve-diaphragm tissues were obtained from 30 adult Sprague-Dawley rats...
April 25, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29685615/effectiveness-and-safety-of-continuous-neuromuscular-blockade-in-trauma-patients-with-an-open-abdomen-a-follow-up-study
#9
Susan E Smith, Susan E Hamblin, Oscar D Guillamondegui, Oliver L Gunter, Bradley M Dennis
BACKGROUND: Neuromuscular blocking agents (NMBA) have been associated with decreased time to fascial closure following damage control laparotomy (DCL). Changes in resuscitation over the last decade bring this practice into question. METHODS: A retrospective cohort study of adults who underwent DCL between 2009 and 2015 was conducted at an ACS-verified level 1 trauma center. The study group (NMBA+) received continuous NMBA within 24 h of DCL. Data collected included demographics, resuscitative fluids, mortality, and complications...
April 18, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29662906/quantitative-relationships-between-pulmonary-function-and-residual-neuromuscular-blockade
#10
ShuYing Fu, WenDong Lin, XiNing Zhao, ShengJin Ge, ZhangGang Xue
Background: Neuromuscular blockade is a risk factor for postoperative respiratory weakness during the immediate postoperative period. The quantitative relationships between postoperative pulmonary-function impairment and residual neuromuscular blockade are unknown. Methods: 113 patients who underwent elective laparoscopic cholecystectomy were enrolled in this study. They all had a pulmonary-function test (PFT) during the preoperative evaluation. Predictive values based on demographic data were also recorded...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29643557/reversal-agents-do-we-need-to-administer-with-neuromuscular-monitoring-an-observational-study
#11
Shilpa Goyal, Nikhil Kothari, Deepak Chaudhary, Shilpi Verma, Pooja Bihani, Mahaveer Singh Rodha
Background and Aims: In clinical practice, in the majority of patients, recovery from the effect of muscle relaxants is assessed using subjective methods such as head lift, eye-opening, or by sustained hand grip after giving anticholinesterases (neostigmine) at the end of surgery. We planned a prospective observational cohort study to test the hypothesis that objective neuromuscular monitoring can help us in avoiding the use of anticholinesterases for reversal. Methods: The patients posted for surgery of <2 h duration were included in the study...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29643554/effectiveness-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-versus-traditional-preoxygenation-followed-by-apnoeic-oxygenation-in-delaying-desaturation-during-apnoea-a-preliminary-study
#12
Sunil Rajan, Nandhini Joseph, Pulak Tosh, Dilesh Kadapamannil, Jerry Paul, Lakshmi Kumar
Background and Aims: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) during apnoea has shown to delay desaturation. The primary objective was to compare time to desaturate to <90% during apnoea with THRIVE versus traditional preoxygenation followed by apnoeic oxygenation. Methods: This prospective, randomised, single-blinded study was conducted in 10 adult patients presenting for direct laryngoscopy under general anaesthesia without endotracheal intubation...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#13
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29628587/effects-of-preoxygenation-with-tidal-volume-breathing-followed-by-apneic-oxygenation-with-and-without-continuous-positive-airway-pressure-on-duration-of-safe-apnea-time-and-arterial-blood-gases
#14
Sunil Rajan, Nandhini Joseph, Pulak Tosh, Jerry Paul, Lakshmi Kumar
Background: Application of continuous positive airway pressure (CPAP) helps to recruit collapsed areas of the lung, which improves the oxygen reserve. Aim of the Study: To compare the time to desaturate to 90% during apnea following preoxygenation and apneic ventilation with tidal volume breathing for 3 min with and without the application of CPAP. Settings and Design: This prospective randomized study was conducted in a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628555/the-role-of-bolus-injection-of-saline-with-arm-elevation-on-rocuronium-onset-time-a-randomized-control-study
#15
Malavika Kulkarni, L S Chuchendra, P J Bhavya
Background: The onset time of neuromuscular blockade is a crucial time associated with the risk of hypoxia and pulmonary aspiration. Various strategies have been undertaken to shorten this onset time. Therefore, we investigated the effects of bolus of 20 ml saline followed by limb elevation after administration of rocuronium in a dose of 0.6 mg/kg to study the onset time. Methodology: Thirty patients were randomly allocated to the bolus saline group or control group...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29621739/incidence-of-hypersensitivity-and-anaphylaxis-with-sugammadex
#16
K Chris Min, Tiffany Woo, Christopher Assaid, Jacqueline McCrea, Deborah M Gurner, Christine McCrary Sisk, Franklin Adkinson, W Joseph Herring
STUDY OBJECTIVE: To evaluate the incidence of hypersensitivity and anaphylaxis after administration of sugammadex. DESIGN: Retrospective analysis. SETTING: Sugammadex clinical development program and post-marketing experience. PATIENTS: Surgical patients and healthy volunteers who received sugammadex or placebo/comparator with anesthesia and/or neuromuscular blockade (NMB). INTERVENTIONS: Sugammadex administered as 2...
June 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29620555/increased-heat-generation-in-postcardiac-arrest-patients-during-targeted-temperature-management-is-associated-with-better-outcomes
#17
Amy J Uber, Sarah M Perman, Michael N Cocchi, Parth V Patel, Sarah E Ganley, Jocelyn M Portmann, Michael W Donnino, Anne V Grossestreuer
OBJECTIVES: Assess if amount of heat generated by postcardiac arrest patients to reach target temperature (Ttarget) during targeted temperature management is associated with outcomes by serving as a proxy for thermoregulatory ability, and whether it modifies the relationship between time to Ttarget and outcomes. DESIGN: Retrospective cohort study. SETTING: Urban tertiary-care hospital. PATIENTS: Successfully resuscitated targeted temperature management-treated adult postarrest patients between 2008 and 2015 with serial temperature data and Ttarget less than or equal to 34°C...
April 3, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29606684/en-route-care-provided-by-us-navy-nurses-in-iraq-and-afghanistan
#18
Virginia S Blackman, Benjamin D Walrath, Lauren K Reeves, Alejandra G Mora, Joseph K Maddry, Zsolt T Stockinger
BACKGROUND: US Navy nurses provide en route care for critically injured combat casualties without having a formal program for training, utilization, or evaluation. Little is known about missions supported by Navy nurses. OBJECTIVES: To characterize the number and types of patients transported and skill sets required by Navy nurses during 2 combat support deployments. METHODS: All interfacility casualty transfers between 2 separate facilities in Iraq and Afghanistan were assessed...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29577894/bilateral-quinolinic-acid-induced-lipid-peroxidation-decreased-striatal-monoamine-levels-and-neurobehavioral-deficits-are-ameliorated-by-gip-receptor-agonist-d-ala-2-gip-in-rat-model-of-huntington-s-disease
#19
Mahip K Verma, Rajan Goel, Krishnadas Nandakumar, Kumar V S Nemmani
Huntington's disease (HD) is an inherited complex progressive neurodegenerative disorder with an established etiopathology linked to neuronal oxidative stress and corticostriatal excitotoxicity. Present study explores the effects of glucose-dependent insulinotropic polypeptide (GIP) receptor agonist on the neurobehavioral sequelae of quinolinic acid-induced phenotype of Huntington's disease in rats. Bilateral administration of quinolinic acid (300 nmol/4µL) to the rat striatum led to characteristic deficits in, locomotor activity, motor coordination, neuromuscular coordination and short-term episodic memory...
March 22, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29554444/predicting-adverse-perioperative-events-in-patients-undergoing-primary-cleft-palate-repair
#20
Marten N Basta, John E Fiadjoe, Albert S Woo, Kenneth N Peeples, Oksana A Jackson
OBJECTIVE: This study aimed to identify risk factors for adverse perioperative events (APEs) after cleft palatoplasty to develop an individualized risk assessment tool. DESIGN: Retrospective cohort. SETTING: Tertiary institutional. PATIENTS: Patients younger than 2 years with cleft palate. INTERVENTIONS: Primary Furlow palatoplasty between 2008 and 2011. MAIN OUTCOME MEASURE(S): Adverse perioperative event, defined as laryngo- or bronchospasm, accidental extubation, reintubation, obstruction, hypoxia, or unplanned intensive care unit admission...
April 2018: Cleft Palate-craniofacial Journal
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