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https://www.readbyqxmd.com/read/28070654/anesthesia-management-of-cesarean-section-in-parturient-with-anti-n-methyl-d-aspartate-receptor-encephalitis-a-case-report
#1
Zhimin Liao, Xiaoqin Jiang, Juan Ni
A 24-year-old woman at 29 weeks' gestation, and with psychiatric symptoms, was admitted to hospital and diagnosed as having anti-N-methyl-D-aspartate receptor encephalitis. After 4 weeks of immunotherapy with little effect, an emergency cesarean section was performed at 33(+4) weeks gestation under general anesthesia. The parturient was intubated after rapid sequence induction with etomidate, remifentanil and succinylcholine. Anesthesia was maintained with sevoflurane and remifentanil. Except for low weight, the infant was normal at birth...
January 9, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28045723/rate-dependent-left-bundle-branch-block-in-an-ambulatory-surgery-patient-a-case-report
#2
Ashraf Farag, Justin Tsai, Sam Deeb, Deidre Putman-Garcia, John D Wasnick, Lydia A Conlay
A 52-year-old woman, ASA II (American Society of Anesthesia classification II) scheduled for cholecystectomy in an ambulatory center, exhibited a wide-complex tachycardia with ectopy on the monitor after induction with propofol and succinylcholine. Blood pressure remained stable; amiodarone was administered for presumed ventricular tachycardia. A 12-lead electrocardiogram (ECG) showed a new left bundle branch block (LBBB) at 98 beats per minute (bpm), which resolved when the heart rate slowed. Surgery was postponed, and both the LBBB and ectopy recurred frequently during the next 24 hours in the intensive care unit, particularly at heart rates >90 bpm...
February 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28011884/pharmacogenetics-and-pathophysiology-of-cacna1s-mutations-in-malignant-hyperthermia
#3
Teresa Ann Beam, Emily F Loudermilk, David F Kisor
A review of the pharmacogenetics (PGt) and pathophysiology of calcium voltage-gated channel subunit alpha1 S (CACNA1S) mutations in malignant hyperthermia susceptibility type 5 (MHS5; MIM #60188) is presented. Malignant hyperthermia (MH) is a life-threatening hypermetabolic state of skeletal muscle usually induced by volatile, halogenated anesthetics and/or the depolarizing neuromuscular blocker succinylcholine. In addition to ryanodine receptor 1 (RYR1) mutations, several CACNA1S mutations are known to be risk factors for increased susceptibility to MH (MHS)...
December 23, 2016: Physiological Genomics
https://www.readbyqxmd.com/read/28009618/electroconvulsive-therapy-considerations-for-transgendered-patients
#4
Billy K Tran, Stephen E O'Donnell, Agnes Balla, David C Adams, Lydia S Grondin, Mitchell H Tsai
As the transgender patient population continues to grow, health care providers will need to become aware of elements unique to the transgender community in order to provide the highest quality of care. Neuromuscular blockade with succinylcholine is routinely administered to patients undergoing electroconvulsive therapy (ECT). Decreased amounts or activity of pseudocholinesterase in serum can lead to prolonged duration of muscle paralysis. Causes of reduced action by pseudocholinesterase include genetically abnormal enzymes, reduced hepatic production, pregnancy, and various drug interactions...
December 21, 2016: Journal of ECT
https://www.readbyqxmd.com/read/27984222/succinylcholine-for-emergency-airway-rescue-in-class-b-ambulatory-facilities-the-society-for-ambulatory-anesthesia-position-statement
#5
Girish P Joshi, Meena S Desai, Steven Gayer, Hector Vila
Procedures in class B ambulatory facilities are performed exclusively with oral or IV sedative-hypnotics and/or analgesics. These facilities typically do not stock dantrolene because no known triggers of malignant hyperthermia (ie, inhaled anesthetics and succinylcholine) are available. This article argues that, in the absence of succinylcholine, the morbidity and mortality from laryngospasm can be significant, indeed, higher than the unlikely scenario of succinylcholine-triggered malignant hyperthermia. The Society for Ambulatory Anesthesia (SAMBA) position statement for the use of succinylcholine for emergency airway management is presented...
December 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27914146/pregnancy-and-delivery-in-a-generalized-dystonia-patient-treated-with-internal-globus-pallidal-deep-brain-stimulation-a-case-report
#6
Hye Ran Park, Jae Meen Lee, Hyeyoung Park, Chae Won Shin, Han Joon Kim, Hee Pyoung Park, Dong Gyu Kim, Beom Seok Jeon, Sun Ha Paek
Internal globus pallidus (GPi) deep brain stimulation (DBS) has been widely accepted as an effective treatment modality of medically refractory dystonia. However, there have been few studies regarding the safety issue of pregnancy and childbirth related with DBS. This report describes a female patient who was pregnant and delivered a baby after GPi DBS surgery. A 33-year-old female patient with acquired generalized dystonia underwent bilateral GPi DBS implantation. She obtained considerable improvement in both movement and disability after DBS implantation...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27871592/stability-of-suxamethonium-in-pharmaceutical-solution-for-injection-by-validated-stability-indicating-chromatographic-method
#7
William Beck, Sofiane Kabiche, Issa-Bella Balde, Sandra Carret, Jean-Eudes Fontan, Salvatore Cisternino, Joël Schlatter
STUDY OBJECTIVE: To assess the stability of pharmaceutical suxamethonium (succinylcholine) solution for injection by validated stability-indicating chromatographic method in vials stored at room temperature. METHODS: The chromatographic assay was achieved by using a detector wavelength set at 218 nm, a C18 column, and an isocratic mobile phase (100% of water) at a flow rate of 0.6 mL/min for 5 minutes. The method was validated according to the International Conference on Harmonization guidelines with respect to the stability-indicating capacity of the method including linearity, limits of detection and quantitation, precision, accuracy, system suitability, robustness, and forced degradations...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871555/anesthetic-implications-for-patients-with-segawa-syndrome
#8
Kathryn E Howze, Nicholas D Will, Bryan T Klassen, Juraj Sprung, Toby N Weingarten
STUDY OBJECTIVE: To characterize the perioperative course of patients with Segawa syndrome undergoing anesthetic management. DESIGN: Retrospective observational case study. SETTING: Large tertiary medical center. PATIENTS: Patients with Segawa syndrome who underwent procedures requiring anesthetic management at our institution from January 1, 2004, through July 31, 2015. MEASUREMENTS: The health records of patients with Segawa syndrome...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27861260/a-case-series-of-life-threatening-succinylcholine-induced-anaphylaxis
#9
Matthieu Le Dorze, Benoit Plaud, Alexandre Mebazaa
No abstract text is available yet for this article.
November 16, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27843744/delayed-recovery-from-paralysis-associated-with-plasma-cholinesterase-deficiency
#10
Wenqin Zhou, Sheng Lv
INTRODUCTION: This case was to describe a patient presented a 6 h length of apnea associated with low cholinesterase activity. CASE DESCRIPTION: A 32 years old female patient (body weight 50 kg, height 160 cm) was admitted to the hospital for laparoscopy combined with hysteroscopy exploration. The preoperative interrogation revealed no significant personal or family history of adverse reaction to anesthetics. The patient was healthy, with no chronic or systemic disease...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27833478/comparison-of-rocuronium-at-two-different-doses-and-succinylcholine-for-endotracheal-intubation-in-adult-patients-for-elective-surgeries
#11
S G Chavan, S Gangadharan, A K Gopakumar
BACKGROUND: The effects of rocuronium at two different doses, that is, 0.6 mg/kg (2 × ED95) and 0.9 mg/kg (3 × ED95), were compared with succinylcholine (2 mg/kg) when used for endotracheal intubation in adult patients for elective surgeries under general anesthesia. MATERIALS AND METHODS: Ninety patients were divided into three groups of 30 each. Groups A, B received injection rocuronium at 0.6 mg/kg, 0.9 mg/kg respectively and Group C received succinylcholine at 2 mg/kg...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27823870/update-does-rocuronium-create-better-intubating-conditions-than-succinylcholine-for-rapid-sequence-intubation
#12
EDITORIAL
Julie L Welch, Rawle A Seupaul
No abstract text is available yet for this article.
November 4, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27815173/stable-gastric-pentadecapeptide-bpc-157-and-bupivacaine
#13
Gordana Zivanovic-Posilovic, Diana Balenovic, Ivan Barisic, Dean Strinic, Vasilije Stambolija, Mario Udovicic, Sandra Uzun, Domagoj Drmic, Josipa Vlainic, Martina Lovric Bencic, Aleksandra Sindic, Sven Seiwerth, Predrag Sikiric
Bupivacaine toxicity following accidental overdose still lacks therapeutic solution. However, there are major arguments for testing BPC 157 against bupivacaine toxicity in vivo in rats, in particular, and then finally, in vitro. These are: the lack of any known BPC 157 toxicity, a lifesaving effect via the mitigation of arrhythmias in rats underwent hyperkalemia or digitalis toxicity, the elimination of hyperkalemia and arrhythmias in rats underwent succinylcholine toxicity and finally, the reduction of potassium-induced depolarization in vitro (in HEK293 cells) in severe hyperkalemia...
December 15, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27796041/optimal-anesthetic-regimen-for-ambulatory-laser-microlaryngeal-surgery
#14
Hyub Huh, Seol Ju Park, Hyong Hwan Lim, Kwang Yoon Jung, Seung-Kuk Baek, Seung Zhoo Yoon, Hye Won Lee, Hye Ja Lim, Jang Eun Cho
OBJECTIVES/HYPOTHESIS: Laser microlaryngeal surgery (LMS) is a short operation requiring brief and intense paralysis. Adequate muscle relaxation and rapid recovery of neuromuscular function are essential for improving surgical conditions and reducing the incidence of complications during LMS. However, the ideal muscle relaxant with a rapid onset and short duration of action is not yet available. Rocuronium has rapid onset at higher doses, but with a prolonged duration of action. Sugammadex is a selective relaxant-binding agent that allows for rapid reversal of rocuronium-induced neuromuscular blockade...
October 31, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27752976/pharmacogenomics-and-pharmacogenetics-for-the-intensive-care-unit-a-narrative-review
#15
Meghan MacKenzie, Richard Hall
PURPOSE: Knowledge of how alterations in pharmacogenomics and pharmacogenetics may affect drug therapy in the intensive care unit (ICU) has received little study. We review the clinically relevant application of pharmacogenetics and pharmacogenomics to drugs and conditions encountered in the ICU. SOURCE: We selected relevant literature to illustrate the important concepts contained within. PRINCIPAL FINDINGS: Two main approaches have been used to identify genetic abnormalities - the candidate gene approach and the genome-wide approach...
January 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27727068/accuracy-of-rapid-sequence-intubation-medication-dosing-in-obese-patients-intubated-in-the-ed
#16
Rahul Bhat, Maryann Mazer-Amirshahi, Christie Sun, Janelle Vaughns, Maria Dynin, Eshetu Tefera, Daryn Towle, Munish Goyal
OBJECTIVE: There are limited data regarding appropriateness of sedative and paralytic dosing of obese patients undergoing rapid sequence intubation (RSI) in the emergency department. The goal of this study was to compare rates of appropriate succinylcholine and etomidate doses in obese and nonobese patients. METHODS: Retrospective review using a database of endotracheally intubated patients using RSI in an urban, tertiary care academic emergency department, from November 2009 to June 2011...
December 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27692755/apnea-after-low-dose-ketamine-sedation-during-attempted-delayed-sequence-intubation
#17
Brian E Driver, Robert F Reardon
Some patients are agitated and unable to tolerate conventional preoxygenation methods, including face mask oxygen or noninvasive positive-pressure ventilation. Sedation with ketamine for preoxygenation, also known as delayed sequence intubation, is a technique that can be used to achieve preoxygenation in this patient population. No complications of delayed sequence intubation have previously been reported. A 60-year-old woman presented with acute hypoxic respiratory failure. Despite application of high-flow oxygen (60 L/min) with a nonrebreather face mask, her oxygen saturation remained at 93%...
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27646281/collective-review-of-the-status-of-rapid-sequence-intubation-drugs-of-choice-in-trauma-in-low-and-middle-income-settings-prehospital-emergency-department-and-operating-room-setting
#18
Leressè Pillay, Timothy Hardcastle
INTRODUCTION: Establishing a definitive airway in order to ensure adequate ventilation and oxygenation is an important aspect of resuscitation of the polytrauma patient . AIM: To review the relevant literature that compares the different drugs used for rapid sequence intubation (RSI) of trauma patients, specifically reviewing: premedication, induction agents and neuromuscular blocking agents across the prehospital, emergency department and operating room setting, and to present the best practices based on the reviewed evidence...
September 19, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27644058/muscle-relaxation-with-succinylcholine-in-electroconvulsive-therapy
#19
Erin H Li, Ethan O Bryson, Charles H Kellner
No abstract text is available yet for this article.
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27633384/clinical-protocol-for-the-management-of-malignant-hyperthermia
#20
A Kollmann-Camaiora, E Alsina, A Domínguez, B Del Blanco, M J Yepes, J L Guerrero, A García
Malignant hyperthermia is a hypermetabolic syndrome that appears in susceptible patients after exposure to certain anaesthetic drugs (succinylcholine, inhalation anaesthetics). Its incidence in Spain is 1 in 40,000 adults, with a 10% mortality rate. It is induced by an abnormal regulation of the ryanodine receptors, producing a massive release of calcium from the sarcoplasmic reticulum in the striate muscle. Clinical manifestations include: CO2 increase, tachycardia, haemodynamic instability, metabolic and respiratory acidosis, profuse sweating, hyperpyrexia, CPK increase, myoglobinuria, kidney failure, disseminated intravascular coagulation (DIC), and ending in cardiac arrest...
January 2017: Revista Española de Anestesiología y Reanimación
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