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Neuromuscular blocking agents

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https://www.readbyqxmd.com/read/29791482/impact-of-high-versus-low-dose-neuromuscular-blocking-agent-administration-on-unplanned-30-day-readmission-rates-in-retroperitoneal-laparoscopic-surgery
#1
Martijn Boon, Chris Martini, H Keri Yang, Shuvayu S Sen, Rob Bevers, Michiel Warlé, Leon Aarts, Marieke Niesters, Albert Dahan
Recent data shows that a neuromuscular block (NMB) induced by administration of high doses of rocuronium improves surgical conditions in certain procedures. However, there are limited data on the effect such practices on postoperative outcomes. We performed a retrospective analysis to compare unplanned 30-day readmissions in patients that received high-dose versus low-dose rocuronium administration during general anesthesia for laparoscopic retroperitoneal surgery. This retrospective cohort study was performed in the Netherlands in an academic hospital where routine high-dose rocuronium NMB has been practiced since July 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29756064/neuromuscular-monitoring-an-update
#2
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/29745620/non-ventilatory-therapies-for-acute-respiratory-distress-syndrome
#3
Jérémy Bourenne, Sami Hraiech, Romain Rambaud, Jean-Marie Forel, Nicolas Persico, Christophe Guervilly, Laurent Papazian
Acute respiratory distress syndrome (ARDS) commonly affects intensive care unit patients and is associated with high mortality. In addition to etiologic treatment and protective ventilation, non-ventilatory therapies represent a significant part of ARDS care. Pharmacological treatments, extra corporeal devices and prone positioning are commonly grouped under this term. Studies have evaluated the individual effects of some of these non- ventilatory therapies in large randomized controlled trials. Recent advances concerning the beneficial use of neuromuscular blocking agents and prone positioning deserve attention...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29744239/neuromuscular-block-and-blocking-agents-in-2018
#4
Christoph Unterbuchner
No abstract text is available yet for this article.
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29706811/use-of-neuromuscular-blocking-agents-in-acute-respiratory-distress-syndrome
#5
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/29705688/survey-of-how-different-groups-of-veterinarians-manage-the-use-of-neuromuscular-blocking-agents-in-anesthetized-dogs
#6
Manuel Martin-Flores, Daniel M Sakai, Luis Campoy, Robin D Gleed
OBJECTIVE: To analyze practice habits associated with the use, reversal and monitoring of nondepolarizing neuromuscular blocking agents (NMBAs) in dogs by different groups of veterinarians. STUDY DESIGN: Online anonymous survey to veterinarians. POPULATION: Data from 390 answered surveys. METHODS: A questionnaire was sent to e-mail list servers of the American College of Veterinary Anesthesia and Analgesia (ACVAA-list), Sociedad Española de Anestesia y Analgesia Veterinaria (SEEAV-list), Colégio Brasileiro de Anestesiologia Veterinária (Brazilian College of Veterinary Anesthesiology; CBAV-list) and American College of Veterinary Ophthalmologists (ACVO-list) to elicit information regarding use of NMBAs and reversal agents, monitoring techniques, criteria for redosing, reversing and assessing adequacy of recovery of neuromuscular function...
March 23, 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29685615/effectiveness-and-safety-of-continuous-neuromuscular-blockade-in-trauma-patients-with-an-open-abdomen-a-follow-up-study
#7
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/29684989/intradermal-skin-tests-for-rocuronium-and-cisatracurium-in-patients-with-a-history-of-allergy-a-retrospective-study
#8
Yu Yil Kim, Ik Thae Kim, Sung In Shin, So Mang Yim
Background: Neuromuscular blocking agents (NMBAs) are a leading cause of perioperative anaphylaxis. However, the performance of systematic screening skin tests to detect reactions for NMBAs prior to general anesthesia is not recommended. We retrospectively examined intradermal tests (IDTs) for rocuronium and cisatracurium in patients with a history of allergy. Methods: We reviewed the records of patients who underwent IDTs for NMBAs between January 1 and December 31, 2016...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29666602/myasthenia-gravis-induced-by-ipilimumab-in-a-patient-with-metastatic-melanoma
#9
Vera Montes, Sandra Sousa, Fernando Pita, Rui Guerreiro, Cátia Carmona
In daily clinical practice, there is a growing number of patients receiving new biological agents used in the treatment of malignancies. Ipilimumab is a fully humanized monoclonal antibody approved for patients with melanoma. It acts as an immune checkpoint inhibitor, binding and blocking cytotoxic T-lymphocyte antigen-4 in order to increase the antitumor immune response. There are several reports of autoimmune responses after its use. A 74-year-old man developed a mild rash and pruritus a few hours after the second infusion of ipilimumab and 24 h after the third dose of ipilimumab, he presented with shortness of breath, proximal limb muscle weakness, and diplopia...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29609424/synergistic-activities-of-abdominal-muscles-are-required-for-efficient-micturition-in-anesthetized-female-mice
#10
Chuan Zhang, Yingchun Zhang, Yolanda Cruz, Timothy B Boone, Alvaro Munoz
PURPOSE: To characterize the electromyographic activity of abdominal striated muscles during micturition in urethane-anesthetized female mice, and to quantitatively evaluate the contribution of abdominal responses to efficient voiding. METHODS: Cystometric and multichannel electromyographic recordings were integrated to enable a comprehensive evaluation during micturition in urethane-anesthetized female mice. Four major abdominal muscle domains were evaluated: the external oblique, internal oblique, and superior and inferior rectus abdominis...
March 2018: International Neurourology Journal
https://www.readbyqxmd.com/read/29557601/sedation-and-analgesia-in-patients-on-mechanical-ventilation-in-pediatric-intensive-care-units-in-argentina
#11
Pedro Taffarel, German Bonetto, Facundo Jorro Barón, Claudia Meregalli
INTRODUCTION: Children in pediatric intensive care units (PICUs) are exposed to experiencing pain, stress and anxiety due to their disease, treatment or care setting. Adequate sedation and analgesia are key to their care, particularly in patients requiring mechanical ventilation (MV). OBJECTIVE: To determine the usual practice in sedation and analgesia management in patients requiring MV in PICUs in Argentina. MATERIAL AND METHODS: Descriptive, crosssectional, multi-center study conducted by means of e-mailed surveys...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29517573/usefulness-of-basophil-activation-tests-for-diagnosis-of-sugammadex-induced-anaphylaxis
#12
Tatsuo Horiuchi, Akihiko Yokohama, Masaki Orihara, Yukinari Tomita, Akihiro Tomioka, Nagahide Yoshida, Kenichiro Takahashi, Shigeru Saito, Tomonori Takazawa
BACKGROUND: Sugammadex is used to reverse the effects of neuromuscular blocking agents in many cases of general anesthesia. However, there are several reports of anaphylaxis after its use. Skin testing is the gold standard for detecting the causative agent of anaphylaxis. However, due to the lack of validated protocols for skin testing with sugammadex, the diagnostic accuracy might be inadequate. Recently, the basophil activation test (BAT) has been established as a tool to detect the causative agent of anaphylaxis with high sensitivity and specificity...
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29497496/recent-advances-in-neuromuscular-block-during-anesthesia
#13
REVIEW
Martijn Boon, Christian Martini, Albert Dahan
Muscle relaxation is a routine part of anesthesia and has important advantages. However, the lingering effects of muscle relaxants in the postoperative period have historically been associated with postoperative adverse events. Neuromuscular reversal, together with neuromuscular monitoring, is a recognized strategy to reduce the rate of postoperative residual relaxation but has only marginally improved outcome in the past few decades. Sugammadex, a novel reversal agent with unique encapsulating properties, has changed the landscape of neuromuscular reversal and opened up new opportunities to improve patient care...
2018: F1000Research
https://www.readbyqxmd.com/read/29496709/residual-neuromuscular-blockade-in-the-critical-care-setting
#14
Nicole Stawicki, Patty Gessner
Residual neuromuscular blockade is a widespread challenge for providers in the acute care setting that, if left unrecognized or untreated, places patients at higher risk for morbidity and mortality. The condition is estimated to occur in 26% to 88% of patients undergoing general anesthesia. The role of the advanced practice nurse in the acute care setting is to facilitate a safe recovery process by identifying early signs of deterioration and supporting the patient until full muscular strength has returned...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29494403/pharmacokinetic-pharmacodynamic-model-of-cw002-an-investigational-intermediate-neuromuscular-blocking-agent-in-healthy-volunteers
#15
Josh D Kaullen, Joel S Owen, Kim L R Brouwer, Paul M Heerdt, Cynthia A Lien, John J Savarese, Virginia D Schmith
BACKGROUND: CW002 is an investigational nondepolarizing, neuromuscular blocking agent with a rapid onset and intermediate duration of action in animals. This is a single ascending dose, healthy subject study exploring tolerability, pharmacokinetics, and potency. METHODS: Population pharmacokinetic and pharmacokinetic/pharmacodynamic models were developed using plasma drug concentration data from a previously published dose-response study in 28 healthy subjects receiving single doses of CW002 during sevoflurane anesthesia...
June 2018: Anesthesiology
https://www.readbyqxmd.com/read/29491752/preliminary-indications-for-the-use-of-sugammadex-after-its-addition-to-a-formulary-at-a-tertiary-care-children-s-hospital
#16
N'Diris Barry, Joshua C Uffman, Dmitry Tumin, Joseph D Tobias
OBJECTIVES: Neuromuscular blocking agents (NMBAs) are administered to facilitate endotracheal intubation and provide skeletal muscle relaxation in surgical procedures. Sugammadex (Bridion) recently received approval by the United States Food and Drug Administration for reversal of rocuronium and vecuronium-induced neuromuscular blockade thereby providing an alternative to acetylcholinesterase inhibitors such as neostigmine. This quality improvement analysis sought to investigate the clinical reasons and common clinical perceptions for choosing sugammadex over neostigmine to reverse NMBAs...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29491207/method-for-prediction-of-efficacy-of-sugammadex-administered-to-recover-from-rocuronium-induced-neuromuscular-blockade-in-gynecological-laparoscopic-surgery-cases
#17
Koji Kimura, Kazuya Omura, Tetsuya Hoshino, Hiroyuki Takahashi, Masaharu Imaura, Yasuhiko Yamada
Sugammadex (SDX), a neuromuscular blocking-reversal agent, quickly reverses neuromuscular blockade induced by rocuronium (RCR). SDX dosage is set according to the state of neuromuscular blockade determined with a neuromuscular monitoring device. However, in clinical situations, such a devise is not frequently used. Here, we report construction of a method for theoretically setting SDX dose by which the optimum reverse time (RT) can be obtained for individual patients even when the device is not available. The subjects were 42 adult female patients who underwent laparoscopic surgery from 1 August 2015 to 31 March 2016, during which RCR and SDX were administered...
2018: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/29483465/-coronary-artery-bypass-surgery-for-the-patient-with-a-history-of-anaphylaxis-due-to-neuromuscular-blocking-agent-report-of-a-case
#18
Masashi Toyama, Tomonobu Abe, Masato Nakayama, Tetsuyuki Takahashi, Tomoka Shiba, Chihiro Nakajima
We present herein a patient with rocuronium anaphylaxis, which had been identified using skin test, underwent conventional coronary artery bypass surgery without any neuromuscular blocking agent. Immobility was achieved with sedatives and analgesics.
February 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29479387/use-of-sugammadex-in-a-patient-with-myotonic-dystrophy
#19
Samira Ahmed, Aymen Naguib, Dmitry Tumin, Joseph D Tobias
One of the challenges during the perioperative care of patients with myotonic dystrophy is the reversal of neuromuscular blocking agents. Agents that inhibit acetylcholinesterase, such as neostigmine, may precipitate myotonia, and are therefore relatively contraindicated. Sugammadex is a novel pharmacologic agent, which encapsulates rocuronium or vecuronium, thereby reversing their effect. We report anecdotal experience with the use of sugammadex to reverse neuromuscular blockade in a patient with myotonic dystrophy...
February 2018: Cardiology Research
https://www.readbyqxmd.com/read/29477296/comparison-of-basophil-activation-test-and-skin-testing-performances-in-nmba-allergy
#20
Pascale Dewachter, Sylvie Chollet-Martin, Claudie Mouton-Faivre, Luc de Chaisemartin, Pascale Nicaise-Roland
BACKGROUND: Neuromuscular blocking agents (NMBAs) are the main agents involved during perioperative immediate hypersensitivity. The etiological diagnosis (IgE-mediated allergy vs nonallergy) is linked to the clinical presentation together with tryptase and histamine levels and skin test results. The role of basophil activation test (BAT) needs to be better defined in this setting. OBJECTIVES: To assess the role of BAT compared with the results of skin testing in 31 patients experiencing immediate NMBA hypersensitivity and compare skin test results and BAT performances in the identification of alternative NMBAs...
February 22, 2018: Journal of Allergy and Clinical Immunology in Practice
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