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https://www.readbyqxmd.com/read/28606652/rocuronium-versus-suxamethonium-for-rapid-sequence-induction-of-general-anaesthesia-for-caesarean-section-influence-on-neonatal-outcomes
#1
M Kosinova, P Stourac, M Adamus, D Seidlova, T Pavlik, P Janku, I Krikava, Z Mrozek, M Prochazka, J Klucka, R Stoudek, I Bartikova, H Harazim, H Robotkova, K Hejduk, Z Hodicka, M Kirchnerova, J Francakova, L Obare Pyszkova, J Hlozkova, P Sevcik
BACKGROUND: In a previous study we compared rocuronium and suxamethonium for rapid-sequence induction of general anaesthesia for caesarean section and found no difference in maternal outcome. There was however, a significant difference in Apgar scores. As this was a secondary outcome, we extended the study to explore this finding on a larger sample. METHODS: We included 488 parturients of whom 240 were women from the original study. Women were randomly assigned to receive either rocuronium 1mg/kg (ROC n=245) or suxamethonium 1mg/kg (SUX n=243) after propofol 2mg/kg...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28582801/emergency-airway-management-in-australian-and-new-zealand-emergency-departments-a-multicentre-descriptive-study-of-3710-emergency-intubations
#2
Hatem Alkhouri, John Vassiliadis, Matthew Murray, John Mackenzie, Alex Tzannes, Sally McCarthy, Toby Fogg
OBJECTIVE: The aim of this study was to describe the practice of endotracheal intubation across a range of Australasian EDs. METHODS: We established a multicentre airway registry (The Australian and New Zealand Emergency Department Airway Registry [ANZEDAR]) prospectively capturing intubations from 43 Australian and New Zealand EDs over 24 months using the ANZEDAR form. Information recorded included patient demographics, intubation indications, predicted difficulty, rapid sequence induction and endotracheal intubation preparation technique, induction drugs, airway adjuncts and complications...
June 5, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28513831/avoidance-versus-use-of-neuromuscular-blocking-agents-for-improving-conditions-during-tracheal-intubation-or-direct-laryngoscopy-in-adults-and-adolescents
#3
REVIEW
Lars H Lundstrøm, Christophe Hv Duez, Anders K Nørskov, Charlotte V Rosenstock, Jakob L Thomsen, Ann Merete Møller, Søren Strande, Jørn Wetterslev
BACKGROUND: Tracheal intubation during induction of general anaesthesia is a vital procedure performed to secure a patient's airway. Several studies have identified difficult tracheal intubation (DTI) or failed tracheal intubation as one of the major contributors to anaesthesia-related mortality and morbidity. Use of neuromuscular blocking agents (NMBA) to facilitate tracheal intubation is a widely accepted practice. However, because of adverse effects, NMBA may be undesirable. Cohort studies have indicated that avoiding NMBA is an independent risk factor for difficult and failed tracheal intubation...
May 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28498889/uk-anaesthetists-perspectives-and-experiences-of-severe-perioperative-anaphylaxis-nap6-baseline-survey%C3%A2
#4
H I Kemp, T M Cook, M Thomas, N J N Harper
Background: There is limited information on UK anaesthetists' perspectives and experiences of perioperative anaphylaxis. This baseline survey of the Sixth National Audit Project (NAP6) aimed to identify relevant departmental preparedness and practices, and individual experiences, perceptions and drug-avoidance patterns. Methods: All anaesthetists in 356 UK NHS hospitals were invited to complete an electronic survey. Results: 11 104 anaesthetists (77% crude response rate) from 341 (96%) hospitals responded...
May 12, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28422877/suxamethonium-induces-a-prompt-increase-in-the-bispectral-index
#5
Jong Bum Choi, Se Hee Na, Sook Young Lee, Jong Yeop Kim, Sung Yong Park, Ji Eun Kim, Seungbae Hong, Jiwon An, Chung Hoon Park, Yong Chan Kim, Woo Young Park
Upon inducting general anesthesia in the operating room, we have observed a prompt increase in the bispectral index (BIS) after the intravenous injection of suxamethonium. We hypothesized that the cause of this BIS increase is muscle hyperactivity owing to fasciculation. However, no reports have been published regarding this abrupt increase in the BIS upon the induction of general anesthesia by suxamethonium. To investigate the degree of change in the BIS in patients receiving anesthesia with suxamethonium, we performed a prospective observational study of 63 participants who underwent closed reduction for nasal bone fracture...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28258478/in-vitro-diagnosis-of-immediate-drug-hypersensitivity-anno-2017-potentials-and-limitations
#6
REVIEW
I I Decuyper, E A Mangodt, A L Van Gasse, K Claesen, A Uyttebroek, M Faber, V Sabato, C H Bridts, C Mertens, M M Hagendorens, L S De Clerck, Didier G Ebo
BACKGROUND: For most physicians, quantification of drug-specific immunoglobulin E (drug-sIgE) antibodies constitutes the primary in vitro measure to document immediate drug hypersensitivity reactions (IDHR). Unfortunately, this is often insufficient to correctly identify patients with IgE-mediated IDHR and impossible for non-IgE-mediated IDHR that result from alternative routes of basophil and mast cell activation. In these difficult cases, diagnosis might benefit from cellular tests such as basophil activation tests (BAT)...
June 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28164269/anaesthetic-hypersensitivity-reactions-in-france-between-2011-and-2012-the-10th-gerap-epidemiologic-survey
#7
C Tacquard, O Collange, P Gomis, J-M Malinovsky, N Petitpain, P Demoly, S Nicoll, P M Mertes
BACKGROUND: Immediate hypersensitivity reactions during anaesthesia are rare but potentially life-threatening. The epidemiology changes with time and evolving professional practice, and hence needs to be monitored. Our objective was to follow this epidemiology. METHODS: This was a retrospective, observational study in French hospital clinics, conducted by GERAP members (Groupe d'Étude des Réactions Anaphylactoïdes Périopératoires). Consecutive patients seen in allergo-anaesthesia outpatient clinics, who had experienced a hypersensitivity reaction during anaesthesia between 1 January 2011 and 31 December 2012, were included...
March 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27917845/conditions-of-endotracheal-intubation-with-and-without-muscle-relaxant-in-children
#8
COMPARATIVE STUDY
Nermina Rizvanović, Senada Čaušević, Adisa Šabanović
Aim To compare intubation conditions and hemodynamic response of two induction regimens, with or without muscle relaxant using a combination of either fentanyl and propofol or propofol and suxamethonium. Methods A total of 80 children aged 4-12 years were enrolled in a prospective randomized double-blinded study. Children were randomly allocated in two equal groups. In group F induction was done with fentanyl and propofol, while propofol and suxamethonium were used in group S. Intubation conditions were assessed using Copenhagen Consensus Score (CCS), based on ease of laryngoscopy, position of vocal cords, degree of coughing, jaw relaxation and limb movements...
February 1, 2017: Medicinski Glasnik
https://www.readbyqxmd.com/read/27871592/stability-of-suxamethonium-in-pharmaceutical-solution-for-injection-by-validated-stability-indicating-chromatographic-method
#9
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/27859358/six-years-without-pholcodine-norwegians-are-significantly-less-ige-sensitized-and-clinically-more-tolerant-to-neuromuscular-blocking-agents
#10
G H de Pater, E Florvaag, S G O Johansson, Å Irgens, M N H Petersen, A B Guttormsen
BACKGROUND: As a strong inducer of IgE antibodies to substituted ammonium ion epitopes (QAI), pholcodine (PHO) is a postulated cause of allergic anaphylaxis to neuromuscular blocking agents (NMBAs). Three years after withdrawal of PHO in Norway, a significant reduction in IgE sensitization and anaphylaxis reporting was seen. OBJECTIVE: Six-year follow-up study on the effects of PHO withdrawal on IgE sensitization and anaphylaxis reporting. METHODS: From 650 acute consecutive reports (2005-2013) to the Norwegian Network for Anaphylaxis under Anaesthesia (NARA), total number of reports on suspected anaphylactic reactions, number of reactions where NMBAs were administered, number of reactions where serum IgE antibodies (≥0...
May 2017: Allergy
https://www.readbyqxmd.com/read/27857962/functional-analysis-of-ryr1-variants-linked-to-malignant-hyperthermia
#11
Jeremy Stephens, Anja H Schiemann, Cornelia Roesl, Dorota Miller, Sean Massey, Neil Pollock, Terasa Bulger, Kathryn Stowell
Malignant hyperthermia manifests as a rapid and sustained rise in temperature in response to pharmacological triggering agents, e.g. inhalational anesthetics and the muscle relaxant suxamethonium. Other clinical signs include an increase in end-tidal CO2, increased O2 consumption, as well as tachycardia, and if untreated a malignant hyperthermia episode can result in death. The metabolic changes are caused by dysregulation of skeletal muscle Ca(2+) homeostasis, resulting from a defective ryanodine receptor Ca(2+) channel, which resides in the sarcoplasmic reticulum and controls the flux of Ca(2+) ions from intracellular stores to the cytoplasm...
April 2016: Temperature: Multidisciplinary Biomedical Journal
https://www.readbyqxmd.com/read/27525073/anesthetic-management-of-a-patient-with-edwards-syndrome
#12
Stephanie Mifsud, Maureen Bezzina, Simon Paris
The use of suxamethonium in our case was uneventful and despite craniofacial anomalies, airway management was straightforward. This case illustrates that pediatric patients with trisomy 18, presenting with potentially acute life-threatening conditions and requiring emergency major surgery can be managed successfully with a multidisciplinary approach.
August 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27376983/quantification-of-specific-ige-antibodies-in-immediate-drug-hypersensitivity-more-shortcomings-than-potentials
#13
REVIEW
I I Decuyper, D G Ebo, A P Uyttebroek, M M Hagendorens, M A Faber, C H Bridts, L S De Clerck, V Sabato
BACKGROUND: For many physicians, quantification of serum drug-specific IgE (sIgE) antibodies constitutes the first measure in the diagnostic approach of immediate drug hypersensitivity reactions (IDHR). AIM: To review the accuracy and limitations of the main drug-sIgE tests, especially those that are commercially available. METHODS: A literature search was conducted, using the key-words allergy, diagnosis, drugs, hypersensitivity, specific IgE antibodies; this was complemented by the authors' own experience...
September 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/27237801/butyrylcholinesterase-deficiency
#14
REVIEW
Hervé Delacour, Emmanuel Dedome, Sébastien Courcelle, Blandine Hary, Franck Ceppa
Butyrylcholinesterase (EC 3.1.1.8; BChE) is a sister enzyme of acetylcholinesterase. Though BChE lacks obvious physiological functions, it is of toxicological and pharmacological importance in detoxifying or catabolising ester-containing drugs. Furthermore, individuals deficient in BChE appear asymptomatic, apart from a heightened sensitivity to the muscle relaxants suxamethonium and mivacurium, two BChE substrates used as myorelaxant. Although many acquired conditions may affect BChE activity, BChE deficiency is mainly due to mutations in the BCHE gene (OMIM 177400)...
June 1, 2016: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/27234905/-allergy-to-neuromuscular-blocking-agents
#15
Anca-Mirela Chiriac, Pascal Demoly
Allergy to neuromuscular blocking agents (NMBAs) has been the first cause of perioperative anaphylaxis for decades, in most countries. The most frequently involved agents are suxamethonium and rocuronium. The allergy work-up is compulsory to demonstrate or rule out allergy to NMBAs, if there is a compatible clinical history. Doing otherwise exposes the patient to death if the same or related NMBA is re-injected. In cases of true allergy, assessing cross-reactivity to other NMBAs is mandatory. The cross-sensitization hypothesis is presently being investigated and if confirmed, it could allow primary prevention measures to be implemented...
September 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27071438/rocuronium-vs-suxamethonium-for-rapid-sequence-induction
#16
Timothy Knowles, Rebecca Smith
No abstract text is available yet for this article.
April 2016: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/27017772/-a-case-of-left-vertebral-artery-aneurysm-showing-evoked-potentials-on-bilateral-electrode-by-the-left-vagus-nerve-stimulation-to-electromyographic-tracheal-tube
#17
Tatsuo Kadoya, Hirofumi Uehara, Toshinori Yamamoto, Munehiro Shiraishi, Yuki Kinoshita, Takeshi Joyashiki, Kengo Enokida
Previously, we reported a case of brainstem cavernous hemangioma showing false positive responses to electromyographic tracheal tube (EMG tube). We concluded that the cause was spontaneous respiration accompanied by vocal cord movement. We report a case of left vertebral artery aneurysm showing evoked potentials on bilateral electrodes by the left vagus nerve stimulation to EMG tube. An 82-year-old woman underwent clipping of a left unruptured vertebral artery-posterior inferior cerebellar artery aneurysm. General anesthesia was induced with remifentanil, propofol and suxamethonium, and was maintained with oxygen, air, remifentanil and propofol...
February 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26977023/possible-effect-of-muscle-relaxant-anaesthetics-on-invasion-adhesion-and-migration-of-breast-cancer-cells
#18
COMPARATIVE STUDY
Aihua Jiang, Huishan Zhao, Jun Cai, Wen G Jiang
BACKGROUND: Aggressive surgical removal of the primary tumour is the preferred treatment, but with tumour progression, some tumours cannot be completely removed surgically. Anaesthetics are administered to facilitate surgery. However, anaesthetics act as a potential factor in tumour recurrence or metastasis. MATERIALS AND METHODS: Normal breast cells and cancer breast cells were treated with different doses of muscle-relaxant anaesthetics. The effects on breast cancer cell invasion, adhesion and migration of these anaesthetics were then investigated using in vitro models...
March 2016: Anticancer Research
https://www.readbyqxmd.com/read/26957692/intraoperative-hemodynamics-with-vecuronium-bromide-and-rocuronium-for-maintenance-under-general-anesthesia
#19
Alen Mathew, Anish N G Sharma, P Ganapathi, P Shankaranarayana, M Nazim, D S Aiyappa
AIMS: The present study is undertaken to compare the hemodynamic effects using vecuronium versus rocuronium for maintenance in patients undergoing general surgical procedures. SETTINGS AND DESIGN: It is a prospective, randomized, and cohort study. SUBJECTS AND METHODS: 100 patients were randomly divided into two groups. All patients were induced with 5 mg/kg of thiopentone sodium, and intubation conditions were achieved with 1.5 mg/kg of suxamethonium, using a well-lubricated cuffed endotracheal tube of appropriate size...
January 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/26917599/current-practice-of-rapid-sequence-induction-of-anaesthesia-in-the-uk-a-national-survey
#20
A Sajayan, J Wicker, N Ungureanu, C Mendonca, P K Kimani
BACKGROUND: The 'classical' technique of rapid sequence induction (RSI) of anaesthesia was described in 1970. With the introduction of new drugs and equipment in recent years, a wide variation in this technique has been used. The role of cricoid pressure is controversial because of the lack of scientific evidence. Moreover, gentle mask ventilation has been recommended in situations such as obesity and critically ill patients, to prevent hypoxaemia during the apnoeic period. In identifying multiple techniques, we conducted a national postal survey to establish the current practice of RSI in the UK...
September 2016: British Journal of Anaesthesia
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