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https://www.readbyqxmd.com/read/27917845/conditions-of-endotracheal-intubation-with-and-without-muscle-relaxant-in-children
#1
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
#2
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
#3
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...
November 9, 2016: Allergy
https://www.readbyqxmd.com/read/27857962/functional-analysis-of-ryr1-variants-linked-to-malignant-hyperthermia
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/26595234/prolonged-apnea-during-modified-electroconvulsive-therapy-in-a-patient-of-suicidal-attempt-by-organophosphorus-poisoning-a-case-report
#14
Rajesh Dhakne, Kshirod K Mishra, Vinay Kumar, Praveen Khairkar
Organophosphorus (OP) pesticides are commonly used in agricultural fields to control pests in India. However, exposure to it can cause poisoning in humans and animals, or it can be taken intentionally as poison to commit suicide. We present a case of a 35-year-old suicidal man who developed prolonged apnea for almost 4 hours on day 13 of OP poisoning after brief general anesthesia induced by propofol and 1 mg/kg of suxamethonium, during the first session of the third cycle of modified electroconvulsive therapy, despite all due precautions...
June 2016: Journal of ECT
https://www.readbyqxmd.com/read/26585767/rethinking-general-anesthesia-for-cesarean-section
#15
REVIEW
Hiroyiki Sumikura, Hidetomo Niwa, Masaki Sato, Tatsuo Nakamoto, Takashi Asai, Satoshi Hagihira
In this review, we describe the current consensus surrounding general anesthetic management for cesarean section. For induction of anesthesia, rapid-sequence induction using thiopental and suxamethonium has been the recommended standard for a long time. In recent years, induction of anesthesia using propofol, rocuronium, and remifentanil have been gaining popularity. To prevent aspiration pneumonia, a prolonged preoperative fasting and an application of cricoid pressure during induction of anesthesia have been recommended, but these practices may require revision...
April 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/26442411/-a-case-of-brainstem-cavernous-hemangioma-showing-false-positive-response-to-electromyographic-tracheal-tube
#16
Tatsuo Kadoya, Toshinori Yamamoto, Hirofumi Uehara, Yuki Kinoshita, Munehiro Shiraishi, Takeshi Joyashiki, Tomoko Watake, Kengo Enokida
Brainstem cavernous hemangioma is a complex lesion associated with hemorrhage and neurological deficit. The damage of the vagus nerve is a devastating surgical complication. Therefore, intraoperative anatomical and functional evaluation of this nerve is crucial. We used electromyographic tracheal tube (EMG tube)to monitor electromyogram from the vocal cord. We report a case of brainstem cavernous hemangioma showing false positive response to EMG tube. A 66-year-old woman underwent resection of cavernous hemangioma in the pontine tegmentum...
August 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26199407/the-therapeutic-value-of-atropine-for-critical-care-intubation
#17
REVIEW
Peter Jones
Recent studies of atropine during critical care intubation (CCI) have revealed that neonates frequently experience bradycardia, are infrequently affected by ventricular arrhythmias and conduction disturbances and deaths have not been reported in a series of studies. The indiscriminate use of atropine is unlikely to alter the outcome during neonatal CCI other than reducing the frequency of sinus tachycardia. In contrast, older children experience a similar frequency of bradycardia to neonates and are more frequently affected by ventricular arrhythmias and conduction disturbances...
January 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/26190647/tugging-force-a-new-objective-index-for-evaluating-acute-changes-in-neuromuscular-function-in-mice
#18
Shoichi Okada, Kensuke Orito
INTRODUCTION: Many agents, including muscle relaxants, influence neuromuscular function. Although in vitro and in situ measurement systems of skeletal muscular contractility have been developed and in use for years, no convenient device and parameter are available to examine the time course of the acute effects of such agents on neuromuscular function in conscious mice. METHODS: We created a two-compartment device consisting of a transparent, wide, acrylic chamber with a foot shock grid, and an attached, opaque narrow tunnel to measure neuromuscular performance...
November 2015: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/26174308/response-of-bispectral-index-to-neuromuscular-block-in-awake-volunteers
#19
P J Schuller, S Newell, P A Strickland, J J Barry
BACKGROUND: The bispectral index (BIS) monitor is a quantitative electroencephalographic (EEG) device that is widely used to assess the hypnotic component of anaesthesia, especially when neuromuscular blocking drugs are used. It has been shown that the BIS is sensitive to changes in electromyogram (EMG) activity in anaesthetized patients. A single study using an earlier version of the BIS showed that decreased EMG activity caused the BIS to decrease even in awake subjects, to levels that suggested deep sedation and anaesthesia...
July 2015: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26174307/premature-awakening-and-underuse-of-neuromuscular-monitoring-in-a-registry-of-patients-with-butyrylcholinesterase-deficiency
#20
J L Thomsen, C V Nielsen, D F Palmqvist, M R Gätke
BACKGROUND: Patients with butyrylcholinesterase (BChE) deficiency can experience prolonged paralysis after receiving suxamethonium or mivacurium. We hypothesized that patients suspected of BChE deficiency had a higher risk of being awakened while paralysed and having respiratory complications if neuromuscular monitoring was not applied before awakening. METHODS: We retrospectively included patients referred to the Danish Cholinesterase Research Unit between 2004 and 2012 on suspicion of BChE deficiency...
July 2015: British Journal of Anaesthesia
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