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neuromuscular blockade

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https://www.readbyqxmd.com/read/29330589/impact-of-valve-less-vs-standard-insufflation-on-pneumoperitoneum-volume-inflammation-and-peritoneal-physiology-in-a-laparoscopic-sigmoid-resection-experimental-model
#1
Michele Diana, Eric Noll, Andras Legnèr, Seong-Ho Kong, Yu-Yin Liu, Luigi Schiraldi, Francesco Marchegiani, Jordan Bano, Bernard Geny, Anne-Laure Charles, Bernard Dallemagne, Véronique Lindner, Didier Mutter, Pierre Diemunsch, Jacques Marescaux
BACKGROUND: Standard insufflators compensate for intra-abdominal pressure variations with pressure spikes. Our aim was to evaluate the impact of a stable, low-pressure pneumoperitoneum induced by a valve-less insufflator, on working space, hemodynamics, inflammation, and peritoneal physiology, in a model of laparoscopic sigmoid resection. MATERIALS AND METHODS: Twelve pigs (47 ± 3.3 kg) were equipped for invasive hemodynamic monitoring and randomly assigned to Standard (n = 6) vs...
January 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29323413/extracorporeal-membrane-oxygenation-for-refractory-severe-respiratory-failure-in-acute-interstitial-pneumonia
#2
Gabriela Gonçalves-Venade, Nuno Lacerda-Príncipe, Roberto Roncon-Albuquerque, José Artur Paiva
Acute interstitial pneumonia (AIP) is a rare idiopathic interstitial lung disease with rapid progressive respiratory failure and high mortality. In the present report, three cases of AIP complicated by refractory respiratory failure supported with extracorporeal membrane oxygenation (ECMO) are presented. One male and two female patients (ages 27-59) were included. Venovenous ECMO support was provided using miniaturized systems, with two-site femoro-jugular circuit configuration. Despite lung protective ventilation, prone position and neuromuscular blockade, refractory respiratory failure of unknown etiology supervened (ratio of arterial oxygen partial pressure to fractional inspired oxygen 46-130) and ECMO was initiated after 3-7 days of mechanical ventilation...
January 11, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29317806/profile-of-sugammadex-for-reversal-of-neuromuscular-blockade-in-the-elderly-current-perspectives
#3
REVIEW
Michele Carron, Francesco Bertoncello, Giovanna Ieppariello
The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29310829/-sugammadex-by-ideal-body-weight-versus-20-and-40-corrected-weight-in-bariatric-surgery-double-blind-randomized-clinical-trial
#4
Nádia Maria da Conceição Duarte, Ana Maria Menezes Caetano, Silvio da Silva Caldas Neto, Getúlio Rodrigues de Oliveira Filho, Gustavo de Oliveira Arouca, Josemberg Marins Campos
BACKGROUND AND OBJECTIVES: The weight parameters for use of sugammadex in morbidly obese patients still need to be defined. METHODS: A prospective clinical trial was conducted with sixty participants with body mass index≥40kg·m-2 during bariatric surgery, randomized into three groups: ideal weight (IW), 20% corrected body weight (CW20) and 40% corrected body weight (CW40). All patients received total intravenous anesthesia. Rocuronium was administered at dose of 0...
January 5, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29280475/the-comparative-efficacy-and-safety-of-sugammadex-and-neostigmine-in-reversing-neuromuscular-blockade-in-adults-a-cochrane-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#5
REVIEW
A-M Hristovska, P Duch, M Allingstrup, A Afshari
We compared the efficacy and safety of sugammadex and neostigmine in reversing neuromuscular blockade in adults. Our outcomes were: recovery time from second twitch to train-of-four ratio > 0.9; recovery time from post-tetanic count 1-5 to train-of-four ratio > 0.9; and risk of composite adverse and serious adverse events. We searched for randomised clinical trials irrespective of publication status and date, blinding status, outcomes reported or language. We included 41 studies with 4206 participants...
December 27, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29242649/dose-reversal-effect-relationship-of-three-different-doses-of-neostigmine-in-obese-patients-a-randomised-clinical-trial
#6
Satyen Parida, Venkatesan Kausalya, Sandeep Kumar Mishra, Sethuramachandran Adinarayanan
Background and Aims: Previous studies suggest that administration of vecuronium based on total body weight rather than ideal body weight (IBW) in obesity results in overdosing with prolonged recovery times. We hypothesised that larger doses of neostigmine could result in faster recovery in obese patients administered vecuronium based on total body weight. Methods: Forty-five obese American Society of Anesthesiologists' II patients undergoing elective surgery under general anaesthesia were randomised into 3 groups to receive neostigmine 30, 40 and 50 μg/kg...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29239154/neuromuscular-block-in-laparoscopic-surgery
#7
Thomas Fuchs-Buder, Edoardo DE Robertis, Laurent Brunaud
BACKGROUND: There is an increased interest in the current literature to evaluate the potential clinical benefit of a sustained deep neuromuscular blockade ( i.e. a post-tetanic count ≤ 3) during various laparoscopic surgical procedures. This deep block concept represents a new area of clinical research, which concerns both, anesthesiologists and surgeons. METHODS: We reviewed a selection of recent publications about the indications and the potential benefits of a maintained deep neuromuscular blockade during different laparoscopic procedures...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29232220/chasing-unicorns-debunking-the-myths-around-reversal-of-neuromuscular-blockade
#8
Jonathan P Wanderer, James P Rathmell
No abstract text is available yet for this article.
January 2018: Anesthesiology
https://www.readbyqxmd.com/read/29216820/comparison-of-the-effect-of-different-infusion-rates-of-sufentanil-on-surgical-stress-index-during-cranial-pinning-in-children-under-general-anaesthesia-a-randomized-controlled-study
#9
In-Kyung Song, Sang-Hwan Ji, Eun-Hee Kim, Ji-Hyun Lee, Jin-Tae Kim, Hee-Soo Kim
BACKGROUND: Surgical stress index (SSI) is an established indicator for intraoperative nociception. Opioids are used to block stimulus of cranial pinning in neurosurgery. We investigated the effect of different infusion rates of sufentanil on SSI during cranial pinning in children under general anaesthesia. METHODS: Forty-nine children (2-12 years of age) underwent neurosurgery with pinning. The children were randomized into three groups based on the rate of sufentanil infusion: 0...
December 8, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29210718/successful-treatment-of-idiopathic-intractable-hiccup-with-cisatracurium-under-intravenous-general-anesthesia-a-case-report
#10
Jian-Ping Wu, Jian-Xiong An, Xiao-Yan Qian, Yong Wang
We report the successful treatment of idiopathic intractable hiccups with cisatracurium under intravenous general anesthesia. The patient had a history of hiccups for 19 years that were refractory to a variety of treatments. When his hiccups were accompanied by vomiting, insomnia, shortness of breath, and poor oral intake for 9 days, he sought relief. We administered a nondepolarizing muscle relaxant, cisatracurium, during total intravenous anesthesia, to stop the hiccups. The duration of the anesthetic was determined by the time it took for the patient to recover from the neuromuscular blockade without reversal the cisatracurium...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29200077/consensus-statement-on-perioperative-use-of-neuromuscular-monitoring
#11
Mohamed Naguib, Sorin J Brull, Aaron F Kopman, Jennifer M Hunter, Béla Fülesdi, Hal R Arkes, Arthur Elstein, Michael M Todd, Ken B Johnson
A panel of clinician scientists with expertise in neuromuscular blockade (NMB) monitoring was convened with a charge to prepare a consensus statement on indications for and proper use of such monitors. The aims of this article are to: (a) provide the rationale and scientific basis for the use of quantitative NMB monitoring; (b) offer a set of recommendations for quantitative NMB monitoring standards; (c) specify educational goals; and (d) propose training recommendations to ensure proper neuromuscular monitoring and management...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29192867/reduction-of-hyperthermia-in-pediatric-patients-with-severe-traumatic-brain-injury-a-quality-improvement-initiative
#12
Marlina E Lovett, Melissa Moore-Clingenpeel, Onsy Ayad, Nicole O'Brien
OBJECTIVE Severe traumatic brain injury remains a leading cause of morbidity and mortality in the pediatric population. Providers focus on reducing secondary brain injury by avoiding hypoxemia, avoiding hypotension, providing normoventilation, treating intracranial hypertension, and reducing cerebral metabolic demand. Hyperthermia is frequently present in patients with severe traumatic brain injury, contributes to cerebral metabolic demand, and is associated with prolonged hospital admission as well as impaired neurological outcome...
December 1, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29186673/disparate-postsynaptic-induction-mechanisms-ultimately-converge-to-drive-the-retrograde-enhancement-of-presynaptic-efficacy
#13
Pragya Goel, Xiling Li, Dion Dickman
Retrograde signaling systems are fundamental modes of communication synapses utilize to dynamically and adaptively modulate activity. However, the inductive mechanisms that gate retrograde communication in the postsynaptic compartment remain enigmatic. We have investigated retrograde signaling at the Drosophila neuromuscular junction, where three seemingly disparate perturbations to the postsynaptic cell trigger a similar enhancement in presynaptic neurotransmitter release. We show that the same presynaptic genetic machinery and enhancements in active zone structure are utilized by each inductive pathway...
November 28, 2017: Cell Reports
https://www.readbyqxmd.com/read/29178460/the-adequate-rocuronium-dose-required-for-complete-block-of-the-adductor-muscles-of-the-thigh
#14
M Fujimoto, K Kawano, T Yamamoto
BACKGROUND: Rocuronium can prevent the obturator jerk during transurethral resection of bladder tumors. We investigated the adequate rocuronium dose required for complete block of the thigh adductor muscles, and its correlation with individual responses of the adductor pollicis muscle to rocuronium. METHODS: Eleven patients scheduled for transurethral resection of bladder tumors under general anesthesia were investigated. After general anesthesia induction, neuromuscular monitoring of the adductor pollicis muscle and ultrasonography-guided stimulation of the obturator nerve was commenced...
November 26, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29174112/mechanism-of-rhinella-icterica-spix-1824-toad-poisoning-using-in-vitro-neurobiological-preparations
#15
Raquel Soares Oliveira, Allan Pinto Leal, Barbara Ogata, Carlos Gabriel Moreira de Almeida, Douglas Silva Dos Santos, Leandro Homrich Lorentz, Cleci Menezes Moreira, Karla de Castro Figueiredo Bordon, Eliane Candiani Arantes, Tiago Gomes Dos Santos, Cháriston André Dal Belo, Lúcia Vinadé
The biological activity of Rhinella icterica toxic secretion (RITS) was evaluated on chick neuromuscular junctions, rat heart́s tissue and mice hippocampal slices. At chick biventer cervicis preparation, RITS (5, 10 and 20μg/mL) produced a concentration-independent irreversible neuromuscular blockade, which was preceded by a transitory increase of muscle twitch tension with the lowest concentration, in 120minutes recordings. In this set of experiments, RITS incubation partially prevented the curare neuromuscular blockade...
November 23, 2017: Neurotoxicology
https://www.readbyqxmd.com/read/29158500/use-dependent-potentiation-of-voltage-gated-calcium-channels-rescues-neurotransmission-in-nerve-terminals-intoxicated-by-botulinum-neurotoxin-serotype-a
#16
Phillip H Beske, Katie M Hoffman, James B Machamer, Margaret R Eisen, Patrick M McNutt
Botulinum neurotoxins (BoNTs) are highly potent toxins that cleave neuronal SNARE proteins required for neurotransmission, causing flaccid paralysis and death by asphyxiation. Currently, there are no clinical treatments to delay or reverse BoNT-induced blockade of neuromuscular transmission. While aminopyridines have demonstrated varying efficacy in transiently reducing paralysis following BoNT poisoning, the precise mechanisms by which aminopyridines symptomatically treat botulism are not understood. Here we found that activity-dependent potentiation of presynaptic voltage-gated calcium channels (VGCCs) underlies 3,4-diaminopyridine (3,4-DAP)-mediated rescue of neurotransmission in central nervous system synapses and mouse diaphragm neuromuscular junctions fully intoxicated by BoNT serotype A...
November 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29153301/does-neurofunction-monitoring-enhance-nursing-confidence-and-comfort
#17
Holly Ware, Sonja E Stutzman, Lori McGarry, Jenna Bland, DaiWai M Olson
Despite advances in the science of sedation and pain assessment, few studies have examined the impact of various assessment tools on nursing confidence. This study examines how bispextral index monitoring impacts nursing confidence in the assessment and comfort in medication administration based on that assessment. In this prospective observational Quality Improvement project, nurses using bispectral index (BIS) and the Richmond Agitation Sedation Scale (RASS) were randomly selected to complete a self-assessment survey intended to measure their personal confidence and comfort regarding care they were providing for a specific patient on the day the survey was completed...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29145167/contraction-response-to-muscle-percussion-a-reappraisal-of-the-mechanism-of-this-bedside-test
#18
Christoph Czarnetzki, André Truffert, Abdelhafid Mekideche, Antoine Poncet, Christopher Lysakowski, Martin R Tramèr, Michel R Magistris
OBJECTIVE: To study whether the contraction evoked by muscle percussion stems from the excitation of the muscle or of the nerve and to discuss the changes of this response in neuromuscular disorders. METHODS: In 30 neurologically healthy patients undergoing surgery (for ear, nose, or throat problems unrelated to the study) under general anesthesia with propofol and sufentanil we measured with an electrogoniometer the maximal dorsiflexion of the ankle evoked by reflex hammer percussion of the tibialis anterior muscle before and under neuromuscular junction blockade with rocuronium bromide...
October 28, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29140970/clinical-impact-of-external-laryngeal-manipulation-during-laryngoscopy-on-tracheal-intubation-success-in-critically-ill-children
#19
Taiki Kojima, Elizabeth K Laverriere, Erin B Owen, Ilana Harwayne-Gidansky, Asha N Shenoi, Natalie Napolitano, Kyle J Rehder, Michelle A Adu-Darko, Sholeen T Nett, Debbie Spear, Keith Meyer, John S Giuliano, Keiko M Tarquinio, Ronald C Sanders, Jan Hau Lee, Dennis W Simon, Paula A Vanderford, Anthony Y Lee, Calvin A Brown, Peter W Skippen, Ryan K Breuer, Iris Toedt-Pingel, Simon J Parsons, Eleanor A Gradidge, Lily B Glater, Kathleen Culver, Simon Li, Lee A Polikoff, Joy D Howell, Gabrielle Nuthall, Gokul K Bysani, Ana L Graciano, Guillaume Emeriaud, Osamu Saito, Alberto Orioles, Karen Walson, Philipp Jung, Awni M Al-Subu, Takanari Ikeyama, Rakshay Shetty, Kathleen M Yoder, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVES: External laryngeal manipulation is a commonly used maneuver to improve visualization of the glottis during tracheal intubation in children. However, the effectiveness to improve tracheal intubation attempt success rate in the nonanesthesia setting is not clear. The study objective was to evaluate the association between external laryngeal manipulation use and initial tracheal intubation attempt success in PICUs. DESIGN: A retrospective observational study using a multicenter emergency airway quality improvement registry...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#20
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
November 14, 2017: Pediatric Critical Care Medicine
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