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neuromuscular blockade

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https://www.readbyqxmd.com/read/28648715/midbrain-stimulation-evoked-lumbar-spinal-activity-and-fictive-locomotion-in-the-adult-decerebrate-mouse
#1
Katinka Stecina
BACKGROUND: Genetic techniques rendering murine models a popular choice for neuroscience research has led to important insights on neural networks controlling locomotor function. Using genetically altered mouse models for in vivo, electrophysiological studies in the adult state could validate key principles of locomotor network organization that have been described in neonatal, in vitro preparations. NEW METHOD: The experimental model presented here describes a decerebrate, in vivo adult mouse preparation in which focal, electrical midbrain stimulation was combined with monitoring lumbar neural activity and motor output after pre-collicular decerebration and neuromuscular blockade...
June 22, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28643056/deep-neuromuscular-blockade-improves-surgical-conditions-during-low-pressure-pneumoperitoneum-laparoscopic-donor-nephrectomy
#2
D M D Özdemir-van Brunschot, A E Braat, M F P van der Jagt, G J Scheffer, C H Martini, J F Langenhuijsen, R E Dam, V A Huurman, D Lam, F C d'Ancona, A Dahan, M C Warlé
BACKGROUND: Evidence indicates that low-pressure pneumoperitoneum (PNP) reduces postoperative pain and analgesic consumption. A lower insufflation pressure may hamper visibility and working space. The aim of the study is to investigate whether deep neuromuscular blockade (NMB) improves surgical conditions during low-pressure PNP. METHODS: This study was a blinded randomized controlled multicenter trial. 34 kidney donors scheduled for laparoscopic donor nephrectomy randomly received low-pressure PNP (6 mmHg) with either deep (PTC 1-5) or moderate NMB (TOF 0-1)...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28640017/reversal-of-vecuronium-induced-neuromuscular-blockade-with-low-dose-sugammadex-at-train-of-four-count-of-four-a-randomized-controlled-trial
#3
László Asztalos, Zoltán Szabó-Maák, András Gajdos, Réka Nemes, Adrienn Pongrácz, Szabolcs Lengyel, Béla Fülesdi, Edömér Tassonyi
BACKGROUND: Rocuronium-induced neuromuscular block that spontaneously recovered to a train-of-four count of four can be reversed with sugammadex 0.5 or 1.0 mg/kg. We investigated whether these doses of sugammadex can also reverse vecuronium at a similar level of block. METHODS: Sixty-five patients were randomly assigned, and 64 were analyzed in this controlled, superiority study. Participants received general anesthesia with propofol, sevoflurane, fentanyl, and vecuronium...
June 21, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28632620/science-or-fiction-risk-of-postoperative-pneumonia-with-neuromuscular-blockade
#4
R Victor Zhang, Heather Reed, Lawrence J Caruso
No abstract text is available yet for this article.
July 2017: Anesthesiology
https://www.readbyqxmd.com/read/28632619/risk-of-postoperative-pneumonia-with-neuromuscular-blockade-keep-it-simple
#5
Lawrence J Caruso, Heather Reed, R Victor Zhang
No abstract text is available yet for this article.
July 2017: Anesthesiology
https://www.readbyqxmd.com/read/28632617/neuromuscular-blockade-and-risk-of-postoperative-pneumonia
#6
Alex Cumberworth
No abstract text is available yet for this article.
July 2017: Anesthesiology
https://www.readbyqxmd.com/read/28628514/effects-of-dexamethasone-on-sugammadex-reversal-times-of-rocuronium-a-systematic-review-protocol
#7
Cassie R Held, Mackenzie D Sullivan
The objective of the review is to identify the effect of dexamethasone on reversal times of rocuronium when utilizing sugammadex as the reversal agent. The incidence of the prolonged time to extubation in patients who have received concurrent dexamethasone and sugammadex therapies as opposed to those who have not received dexamethasone will also be examined.The proposed PICO question is as follows: In patients undergoing reversal of aminosteroidal neuromuscular blockade with rocuronium, does dexamethasone administration affect sugammadex reversal times, as compared to patients who have not received dexamethasone?...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28624388/geo-economic-variations-in-epidemiology-patterns-of-care-and-outcomes-in-patients-with-acute-respiratory-distress-syndrome-insights-from-the-lung-safe-prospective-cohort-study
#8
John G Laffey, Fabiana Madotto, Giacomo Bellani, Tài Pham, Eddy Fan, Laurent Brochard, Pravin Amin, Yaseen Arabi, Ednan K Bajwa, Alejandro Bruhn, Vladimir Cerny, Kevin Clarkson, Leo Heunks, Kiyoyasu Kurahashi, Jon Henrik Laake, Jose A Lorente, Lia McNamee, Nicolas Nin, Jose Emmanuel Palo, Lise Piquilloud, Haibo Qiu, Juan Ignacio Silesky Jiménez, Andres Esteban, Daniel F McAuley, Frank van Haren, Marco Ranieri, Gordon Rubenfeld, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
BACKGROUND: Little information is available about the geo-economic variations in demographics, management, and outcomes of patients with acute respiratory distress syndrome (ARDS). We aimed to characterise the effect of these geo-economic variations in patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE). METHODS: LUNG SAFE was done during 4 consecutive weeks in winter, 2014, in a convenience sample of 459 intensive-care units in 50 countries across six continents...
June 14, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28614197/sedation-management-in-children-supported-on-extracorporeal-membrane-oxygenation-for-acute-respiratory-failure
#9
James B Schneider, Todd Sweberg, Lisa A Asaro, Aileen Kirby, David Wypij, Ravi R Thiagarajan, Martha A Q Curley
OBJECTIVES: To describe sedation management in children supported on extracorporeal membrane oxygenation for acute respiratory failure. DESIGN: Secondary analysis of prospectively collected data from a multicenter randomized trial of sedation (Randomized Evaluation of Sedation Titration for Respiratory Failure). SETTING: Twenty-one U.S. PICUs. PATIENTS: One thousand two hundred fifty-five children, 2 weeks to 17 years old, with moderate/severe pediatric acute respiratory distress syndrome...
June 13, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28608013/quality-of-recovery-after-low-pressure-laparoscopic-donor-nephrectomy-facilitated-by-deep-neuromuscular-blockade-a-randomized-controlled-study
#10
Denise M D Özdemir-van Brunschot, Gert J Scheffer, Michel van der Jagt, Hans Langenhuijsen, Albert Dahan, Janneke E E A Mulder, Simone Willems, Luuk B Hilbrands, Rogier Donders, Cees J H M van Laarhoven, Frank A d'Ancona, Michiel C Warlé
BACKGROUND: The use of low intra-abdominal pressure (<10 mmHg) reduces postoperative pain scores after laparoscopic surgery. OBJECTIVE: To investigate whether low-pressure pneumoperitoneum with deep neuromuscular blockade improves the quality of recovery after laparoscopic donor nephrectomy (LDN). DESIGN, SETTING AND PARTICIPANTS: In a single-center randomized controlled trial, 64 live kidney donors were randomly assigned to 6 or 12 mmHg insufflation pressure...
June 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28601269/the-bougie-and-first-pass-success-in-the-emergency%C3%A2-department
#11
Brian Driver, Kenneth Dodd, Lauren R Klein, Ryan Buckley, Aaron Robinson, John W McGill, Robert F Reardon, Matthew E Prekker
STUDY OBJECTIVE: The bougie may improve first-pass intubation success in operating room patients. We seek to determine whether bougie use is associated with emergency department (ED) first-pass intubation success. METHODS: We studied consecutive adult ED intubations at an urban, academic medical center during 2013. Intubation events were identified by motion-activated video recording. We determined the association between bougie use and first-pass intubation success, adjusting for neuromuscular blockade, video laryngoscopy, abnormal airway anatomy, and whether the patient was placed in the sniffing position or the head was lifted off the bed during intubation...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28591053/use-of-sugammadex-in-a-patient-with-progressive-muscular-atrophy-and-in-a-patient-with-amyotrophic-lateral-sclerosis-case-report
#12
Jae Hwa Yoo, Soon Im Kim, Sun Young Park, Mi Roung Jun, Yong Eun Kim, Hyoung June Kim
INTRODUCTION: We herein present 2 cases involving the combination of rocuronium and sugammadex in patients with motor neuron disease. The patients were a 54-year-old man with progressive muscular atrophy who underwent removal of internal fixators in the arm and leg, and a 66-year-old woman with amyotrophic lateral sclerosis who underwent skin grafting in the left lower leg. General anesthesia was induced with propofol, rocuronium, and remifentanil and maintained with desflurane and remifentanil...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28573656/objective-neuromuscular-monitoring-of-neuromuscular-blockade-in-denmark-an-online-based-survey-of-current-practice
#13
C M Söderström, K Z Eskildsen, M R Gätke, A K Staehr-Rye
BACKGROUND: Neuromuscular blocking agents are commonly used during general anaesthesia but can lead to postoperative residual neuromuscular blockade and associated morbidity. With appropriate objective neuromuscular monitoring (objNMM) residual blockade can be avoided. In this survey, we investigated the use of objNMM in Denmark. METHODS: We conducted an anonymous Internet-based survey distributed through e-mails to Danish public anaesthesia departments. The survey consisted of 15-17 short questions regarding the use of objNMM...
July 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28573344/-residual-neuromuscular-blockade
#14
T Fuchs-Buder, D Schmartz
Even small degrees of residual neuromuscular blockade, i. e. a train-of-four (TOF) ratio >0.6, may lead to clinically relevant consequences for the patient. Especially upper airway integrity and the ability to swallow may still be markedly impaired. Moreover, increasing evidence suggests that residual neuromuscular blockade may affect postoperative outcome of patients. The incidence of these small degrees of residual blockade is relatively high and may persist for more than 90 min after a single intubating dose of an intermediately acting neuromuscular blocking agent, such as rocuronium and atracurium...
June 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28552090/deep-neuromuscular-blockade-and-low-insufflation-pressure-during-laparoscopic-hysterectomy
#15
Matias Vested Madsen, Olav Istre, Henrik Halvor Springborg, Anne Kathrine Staehr-Rye, Jacob Rosenberg, Jørgen Lund, Mona Ring Gätke
INTRODUCTION: Establishment of sufficient muscle relaxation is essential in laparoscopic surgery. During laparoscopy, surgeons can experience abdominal contractions in their patients. Deep neuromuscular block (NMB) has the potential to prevent such episodes. In this study, we explored if deep NMB reduces the incidence of sudden abdominal contractions as compared with standard NMB. METHODS: This was a pre-planned secondary analysis of a randomized, controlled study...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28542054/quantitative-neuromuscular-blockade-monitoring-two-pictures-of-unexpected-rocuronium-effect-a-case-report
#16
Paul A Leonard, Michael M Todd
Wide variation in responses to neuromuscular blocking agents is well described but typically underappreciated in clinical practice. We present 2 patients with unexpected responses to rocuronium, despite being otherwise unremarkable. Quantitative neuromuscular monitoring provided clear documentation of the events, providing illustrations of these atypical responses.
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28526472/-functional-respiratory-imaging-after-neostigmine-or-sugammadex-enhanced-recovery-from-neuromuscular-blockade-in-the-anesthetised-rat-a-randomised-controlled-pilot-study
#17
Tom Schepens, Guy Cammu, Sabine Maes, Benny Desmedt, Wim Vos, Kristof Deseure
OBJECTIVES: Reductions in diaphragm activity are associated with the postoperative development of atelectasis. Neostigmine reversal is also associated with increased atelectasis. We assessed the effects of neostigmine, sugammadex, and spontaneous reversal on regional lung ventilation and airway flow. METHODS: Six Sprague-Dawley rats were paralysed with rocuronium and mechanically ventilated until recovery of the train-of-four ratio to 0.5. We administered neostigmine (0...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28494905/role-of-sugammadex-in-accelerating-postoperative-discharge-a-meta-analysis
#18
REVIEW
Michele Carron, Francesco Zarantonello, Nadia Lazzarotto, Paola Tellaroli, Carlo Ori
STUDY OBJECTIVE: Sugammadex has been introduced for reversal of neuromuscular blockade (NMB) induced by rocuronium (or vecuronium). Although its efficacy and safety have been established, data are conflicting as to whether it accelerates discharge to the surgical ward compared with neostigmine, which is traditionally used for reversing NMB. The object of this systematic review and meta-analysis was to review the research comparing sugammadex and neostigmine in the context of patient discharge after general anesthesia...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28493510/comparison-of-reversal-with-neostigmine-of-low-dose-rocuronium-vs-reversal-with-sugammadex-of-high-dose-rocuronium-for-a-short-procedure
#19
E S Choi, A Y Oh, B W Koo, J W Hwang, J W Han, K S Seo, S H Ahn, W J Jeong
Some short procedures require deep neuromuscular blockade, which needs to be reversed at the end of the procedure. Forty-four patients undergoing elective laryngeal micro-surgery were randomly allocated into two groups: rocuronium 0.45 mg.kg(-1) with neostigmine (50 μg.kg(-1) with glycopyrrolate 10 μg.kg(-1) ) reversal (moderate block group) vs. rocuronium 0.90 mg.kg(-1) with sugammadex (4 mg.kg(-1) ) reversal (deep block group). The primary outcome was the intubating conditions during laryngoscopy secondary outcomes included recovery of neuromuscular block; conditions for tracheal intubation; satisfaction score as determined by the surgeon; onset of neuromuscular block; and postoperative sore throat...
May 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28492296/italian-consensus-in-neuroradiological-anaesthesia-icona-managing-anaesthesia-during-endovascular-procedures
#20
Carlo A Castioni, Andrea Amadori, Federico Bilotta, Moreno Bolzon, Edoardo Barboni, Anselmo Caricato, Guido Dall'acqua, Francesco DI Paola, Andrea Forastieri Molinari, Paolo Gritti, Italia LA Rosa, Marcello Longo, Carla Maglione, Pietro Martorano, Marina Munari, Valerio Perotti, Frank Rasulo, Maria Ruggiero, Antonio Santoro, Luigia Scudeller, Miriam Tumolo, Anna T Mazzeo
Anaesthetic management of patients undergoing endovascular procedures for treating intracranial aneurysms or cerebrovascular malformations must consider a number of specific challenges, in addition to those associated with anaesthesia for other specialties. In addition to maintenance of physiological stability, manipulation of systemic and cerebral haemodynamic parameters may be required to treat any sudden unexpected catastrophic neurological events. A multidisciplinary group including neuro- and pediatric anaesthesiologists, interventional neuroradiologists, neurosurgeons, and a clinical methodologist contributed to this document...
May 11, 2017: Minerva Anestesiologica
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