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neuromuscular blockade

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https://www.readbyqxmd.com/read/28818054/comparison-of-the-trapezius-and-the-adductor-pollicis-muscle-as-predictor-of-good-intubating-conditions-a-randomized-controlled-trial
#1
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
BACKGROUND: Adequate muscle relaxation is important for ensuring optimal conditions for intubation. Although acceleromyography of the adductor pollicis muscle is commonly used to assess conditions for intubation, we hypothesized that acceleromyography of the trapezius is more indicative of optimal intubating conditions. The primary outcome was the difference between both measurement sites with regard to prediction of good or acceptable intubating conditions. METHODS: Neuromuscular blockade after injection of rocuronium 0...
August 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28806470/efficacy-and-safety-of-sugammadex-versus-neostigmine-in-reversing-neuromuscular-blockade-in-adults
#2
REVIEW
Ana-Marija Hristovska, Patricia Duch, Mikkel Allingstrup, Arash Afshari
BACKGROUND: Acetylcholinesterase inhibitors, such as neostigmine, have traditionally been used for reversal of non-depolarizing neuromuscular blocking agents. However, these drugs have significant limitations, such as indirect mechanisms of reversal, limited and unpredictable efficacy, and undesirable autonomic responses. Sugammadex is a selective relaxant-binding agent specifically developed for rapid reversal of non-depolarizing neuromuscular blockade induced by rocuronium. Its potential clinical benefits include fast and predictable reversal of any degree of block, increased patient safety, reduced incidence of residual block on recovery, and more efficient use of healthcare resources...
August 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28803124/influence-of-depth-of-neuromuscular-blockade-on-surgical-conditions-during-low-pressure-pneumoperitoneum-laparoscopic-cholecystectomy-a-randomized-blinded-study
#3
Javier Barrio, Carlos L Errando, Jaime García-Ramón, Rafael Sellés, Guillermo San Miguel, Juan Gallego
STUDY OBJECTIVE: To evaluate the influence of neuromuscular blockade (NMB) on surgical conditions during low-pressure pneumoperitoneum (8mmHg) laparoscopic cholecystectomy (LC), while comparing moderate and deep NMB. Secondary objective was to evaluate if surgical conditions during low-pressure pneumoperitoneum LC performed with deep NMB could be comparable to those provided during standard-pressure pneumoperitoneum (12mmHg) LC. DESIGN: Prospective, randomized, blinded clinical trial...
August 10, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28802619/sugammadex-efficacy-for-reversal-of-rocuronium-and-vecuronium-induced-neuromuscular-blockade-a-pooled-analysis-of-26-studies
#4
William Joseph Herring, Tiffany Woo, Christopher A Assaid, Robert J Lupinacci, Hendrikus J Lemmens, Manfred Blobner, Karin S Khuenl-Brady
STUDY OBJECTIVE: To summarize and compare efficacy of sugammadex with neostigmine or placebo for reversal of rocuronium- or vecuronium-induced neuromuscular blockade (NMB), and to demonstrate consistency of sugammadex results across various patient populations. DESIGN: Pooled analysis on data from 26 multicenter, randomized, Phase II and III studies. SETTING: Operating room. PATIENTS: 1855 adults undergoing surgery under general anesthesia and receiving rocuronium or vecuronium for NMB...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28800600/botulinum-neurotoxin-c-mutants-reveal-different-effects-of-syntaxin-or-snap-25-proteolysis-on-neuromuscular-transmission
#5
Giulia Zanetti, Stefan Sikorra, Andreas Rummel, Nadja Krez, Elisa Duregotti, Samuele Negro, Tina Henke, Ornella Rossetto, Thomas Binz, Marco Pirazzini
Botulinum neurotoxin serotype C (BoNT/C) is a neuroparalytic toxin associated with outbreaks of animal botulism, particularly in birds, and is the only BoNT known to cleave two different SNARE proteins, SNAP-25 and syntaxin. BoNT/C was shown to be a good substitute for BoNT/A1 in human dystonia therapy because of its long lasting effects and absence of neuromuscular damage. Two triple mutants of BoNT/C, namely BoNT/C S51T/R52N/N53P (BoNT/C α-51) and BoNT/C L200W/M221W/I226W (BoNT/C α-3W), were recently reported to selectively cleave syntaxin and have been used here to evaluate the individual contribution of SNAP-25 and syntaxin cleavage to the effect of BoNT/C in vivo...
August 11, 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28795964/neuromuscular-monitoring-in-the-perioperative-period
#6
Glenn S Murphy
Neuromuscular monitoring devices were introduced into clinical practice in the 1970s. Qualitative neuromuscular monitors, or peripheral nerve stimulators, provide an electrical stimulus to a motor nerve and the response of corresponding muscle subjectively evaluated. A standard peripheral nerve stimulator provides several patterns of nerve stimulation, including train-of-four (TOF), double-burst, tetanic, and post-tetanic count. Qualitative (and quantitative) monitors are needed to determine onset of neuromuscular blockade, maintain the required depth of muscle relaxation during the surgical procedure, and assess an appropriate dose of reversal agent...
August 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28794319/retraction
#7
(no author information available yet)
The below article has been retracted. Article title 「EFFECTS OF OLPRINONE ON NEUROMUSCULAR BLOCKADE CAUSED BY VECURONIUM」Author Takaaki Katayama , Yuhji Saitoh , Chiaki Nemoto , Takahiro Hirama , Tsuyoshi Isosu , Masahiro Murakawa Journal title FUKUSHIMA JOURNAL OF MEDICAL SCIENCE Vol.53, No.2 2007:61-69 Fukushima Medical SocietyEditorial CommitteeJuly 5 , 2017.
2017: Fukushima Journal of Medical Science
https://www.readbyqxmd.com/read/28764269/analysis-of-clinical-indicators-of-quality-in-patients-with-endotracheal-intubation
#8
Sulochana Dash, Sreelatha Balasubramanian
INTRODUCTION: Quality and safety in anaesthesia is usually monitored by analysis of perioperative mortality-morbidity and are influenced by anaesthetic and non-anaesthetic factors. AIM: This study was conducted to analyse the incidence of clinical indicators of quality in endotracheally intubated patients undergoing general abdominal surgeries and obstetric and gynaecological procedures under general anaesthesia and to determine contributing factors for the same...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28763316/effects-of-calcium-chloride-coadministered-with-neostigmine-on-neuromuscular-blockade-recovery-a-double-blind-randomised-study
#9
Jae-Woo Ju, Hyun-Chang Kim, Sehee Yoon, Deok Man Hong, Hee-Pyoung Park
BACKGROUND: Ionised calcium plays an important role in neuromuscular transmission, but its effects on the reversal of nondepolarising neuromuscular blockade have not been fully evaluated. OBJECTIVE: We examined whether calcium chloride coadministered with neostigmine could enhance the rate of neuromuscular recovery. DESIGN: Randomised double-blind trial. SETTING: A tertiary teaching hospital. PATIENTS: In total, 53 patients undergoing elective surgery under general anaesthesia with neuromuscular monitoring by acceleromyography using a TOF-Watch SX monitor...
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28752183/-erratum-to-residual-neuromuscular-blockade
#10
T Fuchs-Buder, D Schmartz
No abstract text is available yet for this article.
July 27, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28739108/use-of-cis-atracurium-to-maintain-moderate-neuromuscular-blockade-in-experimental-pigs
#11
Alexandru Tutunaru, Julien Dupont, Vincent Huberty, Mostafa Ibrahim, Didier Serteyn, Charlotte Sandersen
OBJECTIVE: To determine the dose of cis-atracurium needed to produce a moderate neuromuscular blockade (NMB) in pigs. STUDY DESIGN: Prospective experimental study. ANIMALS: Seven pigs [five females and two males; median (range) body weight: 47 (36-64) kg]. METHODS: Pigs were premedicated with intramuscular midazolam (0.3 mg kg(-1)) and ketamine (7 mg kg(-1)). Anaesthesia was induced with intravenous (IV) propofol 3 (1-4) mg kg(-1) and maintained with isoflurane in oxygen...
April 15, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28720838/the-efficacy-and-safety-of-sugammadex-for-reversing-postoperative-residual-neuromuscular-blockade-in-pediatric-patients-a-systematic-review
#12
Guangyu Liu, Rui Wang, Yanhong Yan, Long Fan, Jixiu Xue, Tianlong Wang
The aim of this study is to evaluate the efficacy and safety of sugammadex for reversing neuromuscular blockade in pediatric patients. MEDLINE and other three Databases were searched. Randomized clinical trials were included if they compared sugammadex with neostigmine or placebo in pediatric patients undergoing surgery involving the use of rocuronium or vecuronium. The primary outcome was the time interval from administration of reversal agents to train-of-four ratio (TOFr, T4/T1) > 0.9. Incidences of any drug-related adverse events were secondary outcomes...
July 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28716645/update-in-management-of-severe-hypoxemic-respiratory-failure
#13
REVIEW
Dharani Kumari Narendra, Dean R Hess, Curtis N Sessler, Habtamu M Belete, Kalpalatha K Guntupalli, Felix Khusid, Charles Mark Carpati, Mark Elton Astiz, Suhail Raoof
Mortality related to severe-moderate and severe ARDS remains high. We searched the literature to update this topic. We defined severe hypoxemic respiratory failure as Pao2/Fio2 < 150 mm Hg (ie, severe-moderate and severe ARDS). For these patients, we support setting the ventilator to a tidal volume of 4 to 8 mL/kg predicted body weight (PBW), with plateau pressure (Pplat) ≤ 30 cm H2O, and initial positive end-expiratory pressure (PEEP) of 10 to 12 cm H2O. To promote alveolar recruitment, we propose increasing PEEP in increments of 2 to 3 cm provided that Pplat remains ≤ 30 cm H2O and driving pressure does not increase...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28714298/effect-of-sugammadex-on-coagulation-as-detected-by-rotational-thromboelastometry-in-morbidly-obese-patients
#14
Michele Carron, Diana Bertini, Tancredi Prandini, Francesca Fanton, Mirto Foletto, Carlo Ori, Egle Perissinotto, Paolo Simioni
BACKGROUND: Sugammadex, which is used to reverse rocuronium-induced neuromuscular blockade, has a limited and transient effect on activated partial thromboplastin time and prothrombin time. However, no data are available on the effects of sugammadex on coagulation in morbidly obese patients, as assessed by rotational thromboelastometry (ROTEM®). METHODS: Sixty patients received sugammadex 2 mg/kg or 4 mg/kg to reverse moderate or deep rocuronium-induced neuromuscular blockade (n = 30/group) at the end of surgery under desflurane anesthesia...
July 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28701612/sugammadex-to-reverse-neuromuscular-blockade-in-a-child-with-a-past-history-of-cardiac-transplantation
#15
Karen Miller, Brian Hall, Joseph D Tobias
Sugammadex is a novel agent for the reversal of neuromuscular blockade. The speed and efficacy of reversal with sugammadex are significantly faster than acetylcholinesterase inhibitors, such as neostigmine. Sugammadex also has a limited adverse profile when compared with acetylcholinesterase inhibitors, specifically in regard to the incidence of bradycardia. This adverse effect may be particularly relevant in the setting of a heart transplant recipient with a denervated heart. The authors present a case of an 8-year-old child, status postcardiac transplantation, who required anesthetic care for laparoscopy and lysis of intra-abdominal adhesions...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28691986/the-role-of-sugammadex-in-symptomatic-transient-neonatal-myasthenia-gravis-a-case-report
#16
Jamie E Rubin, Radhamangalam J Ramamurthi
We describe the case of a 3-week-old boy with pyloric stenosis who presented for laparoscopic pyloromyotomy in the setting of symptomatic transient neonatal myasthenia gravis. The patient received muscle relaxation with rocuronium, and neuromuscular blockade was successfully reversed with sugammadex with recovery guided by train-of-four monitoring. He was extubated uneventfully without complications. Because sugammadex binds directly to rocuronium rather than interfering with acetylcholine metabolism, it might provide a good option for reversal of neuromuscular blockade in transient neonatal myasthenia gravis...
July 6, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28679468/pharmacokinetics-of-sugammadex-in-subjects-with-moderate-and-severe-renal-impairment%C3%A2
#17
K Chris Min, Kenneth C Lasseter, Thomas C Marbury, Rebecca E Wrishko, William D Hanley, Dennis G Wolford, Joanna Udo de Haes, Christina Reitmann, David E Gutstein
AIMS: Sugammadex rapidly reverses moderate and deep rocuronium- or vecuronium-induced neuromuscular blockade at doses of 4 mg/kg and 2 mg/kg, respectively. Sugammadex is renally eliminated. This study evaluated the pharmacokinetics of sugammadex in subjects with renal impairment versus those with normal renal function. METHODS: This open-label, two-part, phase 1 study included adults with moderate (creatinine clearance (CLcr) 30. < 50 mL/min) and severe (CLcr < 30 mL/min) renal impairment and healthy controls (CLcr ≥ 80 mL/min)...
July 6, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28664851/clinical-trials-in-acute-respiratory-distress-syndrome-challenges-and-opportunities
#18
REVIEW
Michael A Matthay, Daniel F McAuley, Lorraine B Ware
This year is the 50th anniversary of the first description of acute respiratory distress syndrome (ARDS). Since then, much has been learned about the pathogenesis of lung injury in ARDS, with an emphasis on the mechanisms of injury to the lung endothelium and the alveolar epithelium. In terms of treatment, major progress has been made in reducing mortality from ARDS with lung-protective ventilation, using a tidal volume of 6 mL per kg of predicted bodyweight and a plateau airway pressure of less than 30 cm H2O...
June 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28662770/monitoring-intraoperative-neuromuscular-blockade-and-blood-pressure-with-one-device-tof-cuff-a-comparative-study-with-mechanomyography-and-invasive-blood-pressure
#19
G Veiga Ruiz, J García Cayuela, J Orozco Montes, M Parreño Caparrós, B García Rojo, J L Aguayo Albasini
OBJECTIVE: The overall objective of the study is to determine the ability of TOF-Cuff device (blood-pressure modified cuff, including stimulation electrodes) to monitor with the same device the non-invasive blood pressure (NIBP) and the depth of a neuromuscular blockade (NMB) induced pharmacologically, by stimulation of the brachial plexus at the humeral level and recording evoked changes in arterial pressure. MATERIAL AND METHOD: Clinical, single-centre, open-controlled study with 32 adult patients ASA I-III for scheduled elective surgery under general anaesthesia in supine position, for the validation of neuromuscular monitoring, comparing the values obtained from neuromuscular relaxation TOF-Cuff with those obtained by mechanomyography (MMG) (control method) during the recovery phase of NMB, when a TOF ratio>0...
June 26, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28658142/use-of-neuromuscular-blockers-and-neostigmine-for-general-anesthesia-and-its-association-with-neuraxial-blockade-a-retrospective-study
#20
Filipe Nadir Caparica Santos, Angélica de Fátima de Assunção Braga, Fernando Eduardo Feres Junqueira, Rafaela Menezes Bezerra, Felipe Ferreira de Almeida, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho
This research aimed to assess the use of neuromuscular blockers (NMB) and its reversal, associated or not with neuraxial blockade, after general anesthesia.This retrospective study analyzed 1295 patients that underwent surgery with general anesthesia at Prof. Dr. José Aristodemo Pinotti Hospital in 2013. The study included patients aged >1 year, with complete, readable medical charts and anesthetic records.Rocuronium (ROC) was the most used NMB (96.7%), with an initial dose of 0.60 (0.52-0.74) mg/kg and total dose of 0...
June 2017: Medicine (Baltimore)
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