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Mohamed Abdulatif, Maha Lotfy, Mahmoud Mousa, Mohamed H Afifi, Khaled Yassen
BACKGROUND: This randomized controlled study compared the recovery times of sugammadex and neostigmine as antagonists of moderate rocuroniuminduced neuromuscular block in patients with liver cirrhosis and controls undergoing liver resection. METHODS: The study enrolled 27 adult patients with Child class "A" liver cirrhosis and 28 patients with normal liver functions. Normal patients and patients with liver cirrhosis were randomized according to the type of antagonist (sugammadex 2mg/kg or neostigmine 50μg/kg)...
February 5, 2018: Minerva Anestesiologica
Marta Romano, Manuel Martin-Flores, Daniel M Sakai, Chia T Tseng, Luis Campoy, Robin D Gleed
OBJECTIVE: Anticholinesterase drugs may produce paradoxical neuromuscular block when administered at shallow levels of neuromuscular block. The objective of this study was to evaluate the effects of neostigmine and edrophonium when administered at near-complete reversal from nondepolarizing block in anesthetized dogs. STUDY DESIGN: Incomplete crossover, randomized, blinded experimental study. ANIMALS: A total of 12 Beagle dogs. METHODS: Each dog was anesthetized twice with propofol and maintained with isoflurane and dexmedetomidine...
November 2017: Veterinary Anaesthesia and Analgesia
Ji Eun Kim, Hea Rim Chun
INTRODUCTION: Anesthetic management of patients with Duchenne muscular dystrophy (DMD) is complicated because these patients are more sensitive to nondepolarizing neuromuscular blocking agents (NMBAs) and are vulnerable to postoperative complications, such as postoperative residual curarization and respiratory failure. Sugammadex is a new reversal agent for aminosteroidal NMBAs, but its safety in children is controversial. CLINICAL FEATURES: An 11-year-old boy with DMD underwent general anesthesia for a percutaneous nephrolithotomy...
March 2017: Medicine (Baltimore)
Ozlem Ozmete, Cagla Bali, Oya Yalcin Cok, Hatice Evren Eker Turk, Nesrın Bozdogan Ozyilkan, Soner Civi, Anıs Aribogan
STUDY OBJECTIVE: To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients. DESIGN: Retrospective observational study. SETTING: University teaching hospital. PATIENTS: Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study...
December 2016: Journal of Clinical Anesthesia
Funda Özel, Ali Aydın Altunkan, Mustafa Azizoğlu
Myasthenia gravis (MG) is an autoimmune disease caused by the development of antibodies against the nicotinic acetylcholine receptor. There is hypersensitivity against non-depolarizing muscle relaxants in these patients. Sugammadex eliminates the effects of steroid non-depolarizing muscle relaxants, such as rocuronium and vecuronium, by selectively encapsulating their molecules. In this case report, we present a case of recurarization and respiratory failure after the use of sugammadex and rocuronium in a patient with preoperatively undiagnosed myasthenia gravis...
April 2016: Turkish Journal of Anaesthesiology and Reanimation
Suchita Parikh, Snehlata Tavri, Shubha Mohite
Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic syndrome of headache, visual changes, altered mental status and seizures with radiologic findings of posterior cerebral white matter edema. It is seen in hypertensive encephalopathy, renal failure, and autoimmune disorders or in patients on immunosuppressants. We report a case of 24-year-old primigravida who presented at term with sudden onset hypertension, neurological deficits, and an episode of the visual blackout. Magnetic resonance imaging showed features suggestive of PRES...
May 2016: Anesthesia, Essays and Researches
Bruno L C Araujo, Alfredo G H Couto, Daniele Theobald
Acute normovolemic hemodilution (ANH) is a blood conservation procedure that can be used in cases of refusal of blood transfusion for religious reasons. Herein, we describe a case of recurarization after reinfusion of collected blood. A combination of rocuronium/sugammadex has the potential to increase the safety of patients if ANH is done after induction. Prospective controlled studies evaluating this unique indication for sugammadex use are thus warranted.
October 2015: Middle East Journal of Anesthesiology
Friederike Haerter, Matthias Eikermann
INTRODUCTION: Acetylcholinesterase inhibitors (neostigmine, edrophonium) and encapsulating agents (sugammadex and calabadion) can be used to reverse residual neuromuscular blockade (NMB). AREAS COVERED: This review provides information about efficacy, effectiveness, and side effects of drugs (acetylcholinesterase inhibitors and encapsulating agents) used to reverse neuromuscular blocking agents (NMBAs). EXPERT OPINION: The therapeutic range of acetylcholinesterase-inhibitors is narrow and effectiveness studies demonstrate clinicians don't use these unspecific reversal agents effectively to increase postoperative respiratory safety...
2016: Expert Opinion on Pharmacotherapy
Ayman A Ghoneim, Mohammed A El Beltagy
BACKGROUND: Postoperative recurarization remains a risk following the use of the conventional neuromuscular blocking agents. In addition, none of the commonly used reversal agents, such as neostigmine or edrophonium are capable of reliably reversing profound blockade. The present comparative and randomized study investigated the use of sugammadex for reversing profound neuromuscular blockade (NMB) in pediatric neurosurgical patients undergone posterior fossa tumor excision. PATIENTS AND METHODS: Forty pediatric patients undergoing elective craniotomy for posterior fossa tumor excision were randomly divided into either of neostigmine or sugammadex group in which muscle relaxant was reversed at the end of anesthesia either with neostigmine 0...
July 2015: Saudi Journal of Anaesthesia
Ronald S Jones, Ulrike Auer, Martina Mosing
OBJECTIVE: To review the evidence regarding the reversal of neuromuscular block (NMB) in companion animals with emphasis on the development and use of newer agents. DATABASE USED: Data sources include scientific reviews and original research publications in both human and veterinary literature using Pubmed and Scopus as search data bases. Unpublished and locally published data on reversal of NMB are presented. CONCLUSIONS: Residual NMB has been shown to increase morbidity and mortality in humans and needs to be avoided...
September 2015: Veterinary Anaesthesia and Analgesia
Junzo Takeda, Hiroshi Iwasaki, Tetsutaro Otagiri, Takasumi Katoh, Koh Shingu, Hidefumi Obara, Hideki Nakatsuka, Yoshinobu Tomiyama, Toshiharu Kasaba
BACKGROUND: Efficacy and safety of sugammadex in reversing neuromuscular block induced by rocuronium or vecuronium were investgated in Japanese patients. METHODS: We studied 99 Japanese patients undergoing surgery requiring general anesthesia. Patients were allocated randomly to receive intubation dose of rocuronium or vecuronium. During surgery, patients received additional dose of rocuronium or vecuronium for maintenance of deep block. At 1-2 PTC, 0.5-8.0 mg ...
October 2014: Masui. the Japanese Journal of Anesthesiology
Junzo Takeda, Hiroshi Iwasaki, Michiaki Yamakage, Makoto Ozaki, Miwako Kawamata, Yoshio Hatano, Toshihiro Yorozuya, Hiroshi Miyakawa, Yuichi Kanmura
BACKGROUND: Efficacy and safety of sugammadex in reversing neuromuscular block induced by rocuronium or vecuronium were investgated in Japanese patients. METHODS: We studied 98 Japanese patients undergoing surgery requiring general anesthesia. Patients were allocated randomly to receive intubation dose of rocuronium or vecuronium. During surgery, patients received additional doses of rocuronium or vecuronium for maintenance of moderate block. At T2 reappearance sugammadex 0-4...
October 2014: Masui. the Japanese Journal of Anesthesiology
Ai Fujita, Natsuki Ishibe, Tatsuya Yoshihara, Jun Ohashi, Hideichi Makino, Mizuko Ikeda, Hidekazu Setoguchi
OBJECTIVE: Sugammadex rapidly reverses neuromuscular blockade (NMB) induced by rocuronium. NMB induced by rocuronium is prolonged in patients with liver dysfunction, because the drug is mainly excreted into the bile. However, the efficacy and safety of sugammadex in terms of reversing rocuronium-induced NMB in patients with liver dysfunction undergoing hepatic surgery have not been evaluated. This observational study investigated the efficacy and safety of sugammadex after continuous infusion of rocuronium in patients with liver dysfunction undergoing hepatic surgery...
June 2014: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
Geng Wang, Jia Wang, Haibin Zhou, Xia Zhao, Xinmin Wu
BACKGROUND: Recurarization has previously been described in the context of acute normovolemic hemodilution. The aim of this study was to investigate the impairment of recovery of neuromuscular function after re-transfusion of intraoperative salvaged blood in patients treated with rocuronium. METHODS: We enrolled 50 patients undergoing general anesthesia for lumbar surgery. Intraoperative blood salvage (IBS) was used in 30 patients (group I); the remaining 20 comprised a control group (group C)...
2014: Chinese Medical Journal
Tatsuhiko Shimizu, Yuichiro Toda, Kazuyoshi Shimizu, Tatsuo Iwasaki, Tomoyuki Kanazawa, Noriko Ishii, Kentaro Sugimoto, Hirokazu Kawase, Kiyoshi Morita
It is known that blood concentration of rocuronium increases after administration of sugammadex, but this is not clear in the case of vecuronium. We report a pediatric case in which serum vecuronium concentration increased following sugammadex administration after prolonged sedation using vecuronium. A 19-month-old girl weighing 7.8 kg had a history of aortic valvuloplasty at 4 months of age due to truncus arteriosus. She presented again to our hospital due to aortic regurgitation. She underwent aortic valvuloplasty and then aortic valve replacement...
October 2013: Masui. the Japanese Journal of Anesthesiology
Masakazu Shibusawa, Yutaka Ejima, Ryou Nishino, Hiroaki Toyama, Shin Kurosawa
Recently, rocuronium is being used in patients for caesarean section undergoing general anesthesia instead of suxamethonium. An increased dose of rocuronium improves intubating conditions but prolongs neuromuscular blockade. Sugammadex reverses rapidly and predictably even profound rocuronium-induced neuromuscular blockade. We experienced 13 cases of caesarean section patients undergoing general anesthesia with thiopental (3.5 mg x kg(-1)) and rocuronium (0.9 mg x kg(-1)). At the end of surgery, sugammadex (2 mg x kg(-1)) was administered every 3 minutes repeatedly until TOF>0...
August 2012: Masui. the Japanese Journal of Anesthesiology
P A Stewart, S Phillips, H D De Boer
Neuromuscular disorders like myotonic dystrophy (dystrophia myotonica or Steinert's disease) and spinal muscular atrophy are associated with perioperative complications related to muscle weakness. These patients have an increased sensitivity to non-depolarising neuromuscular blocking agents, which can lead to postoperative residual curarization (PORC) and its associated respiratory complications. Adequate reversal of neuromuscular blockade is essential to prevent this. Sugammadex is the first selective relaxant binding agent and it reverses rocuronium- and vecuronium-induced neuromuscular block...
April 2013: Revista Española de Anestesiología y Reanimación
Frédérique Le Corre, Salmi Nejmeddine, Chérif Fatahine, Claude Tayar, Jean Marty, Benoît Plaud
PURPOSE: We report a case that involved immediate postoperative respiratory failure necessitating tracheal intubation, which was possibly related to recurarization after sugammadex reversal. CLINICAL FINDINGS: A 54-yr-old woman weighing 115-kg was scheduled for laparoscopic repair of abdominal dehiscence under general anesthesia. Muscle relaxation was induced and maintained with rocuronium (170 mg iv total dose). At the end of the 170-min procedure, two twitches were visualized after supramaximal train-of-four (TOF) stimulation at the adductor pollicis muscle, and the patient's central core temperature was 35...
October 2011: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
T Suzuki, O Kitajima, K Ueda, Y Kondo, J Kato, S Ogawa
BACKGROUND: This study compared the reversibility of rocuronium-induced profound neuromuscular block with sugammadex in younger and older patients. METHODS: Fifteen younger (20-50 yr) and 15 older (≥70 yr) patients were sequentially enrolled in this study. After induction of anaesthesia and laryngeal mask insertion, contraction of the adductor pollicis muscle in response to ulnar nerve stimulation was quantified using acceleromyography during 1.0-1.5% end-tidal sevoflurane and remifentanil anaesthesia...
June 2011: British Journal of Anaesthesia
Stefan J Schaller, Heidrun Fink, Kurt Ulm, Manfred Blobner
INTRODUCTION: Sugammadex effectively and rapidly reverses deep to moderate rocuronium-induced neuromuscular block. However, the required dose of sugammadex for smaller degrees of residual block is unknown. Therefore we investigated the efficacy of sugammadex and neostigmine at a train-of-four (TOF) ratio of 0.5. METHODS: After ethics committee (Munich, Germany) approval and written informed consent were obtained, 99 patients were anesthetized with propofol, remifentanil, and rocuronium...
November 2010: Anesthesiology
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