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monitoring neuromuscular block

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https://www.readbyqxmd.com/read/28658142/use-of-neuromuscular-blockers-and-neostigmine-for-general-anesthesia-and-its-association-with-neuraxial-blockade-a-retrospective-study
#1
Filipe Nadir Caparica Santos, Angélica de Fátima de Assunção Braga, Fernando Eduardo Feres Junqueira, Rafaela Menezes Bezerra, Felipe Ferreira de Almeida, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho
This research aimed to assess the use of neuromuscular blockers (NMB) and its reversal, associated or not with neuraxial blockade, after general anesthesia.This retrospective study analyzed 1295 patients that underwent surgery with general anesthesia at Prof. Dr. José Aristodemo Pinotti Hospital in 2013. The study included patients aged >1 year, with complete, readable medical charts and anesthetic records.Rocuronium (ROC) was the most used NMB (96.7%), with an initial dose of 0.60 (0.52-0.74) mg/kg and total dose of 0...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28573656/objective-neuromuscular-monitoring-of-neuromuscular-blockade-in-denmark-an-online-based-survey-of-current-practice
#2
C M Söderström, K Z Eskildsen, M R Gätke, A K Staehr-Rye
BACKGROUND: Neuromuscular blocking agents are commonly used during general anaesthesia but can lead to postoperative residual neuromuscular blockade and associated morbidity. With appropriate objective neuromuscular monitoring (objNMM) residual blockade can be avoided. In this survey, we investigated the use of objNMM in Denmark. METHODS: We conducted an anonymous Internet-based survey distributed through e-mails to Danish public anaesthesia departments. The survey consisted of 15-17 short questions regarding the use of objNMM...
July 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28573344/-residual-neuromuscular-blockade
#3
T Fuchs-Buder, D Schmartz
Even small degrees of residual neuromuscular blockade, i. e. a train-of-four (TOF) ratio >0.6, may lead to clinically relevant consequences for the patient. Especially upper airway integrity and the ability to swallow may still be markedly impaired. Moreover, increasing evidence suggests that residual neuromuscular blockade may affect postoperative outcome of patients. The incidence of these small degrees of residual blockade is relatively high and may persist for more than 90 min after a single intubating dose of an intermediately acting neuromuscular blocking agent, such as rocuronium and atracurium...
June 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28542054/quantitative-neuromuscular-blockade-monitoring-two-pictures-of-unexpected-rocuronium-effect-a-case-report
#4
Paul A Leonard, Michael M Todd
Wide variation in responses to neuromuscular blocking agents is well described but typically underappreciated in clinical practice. We present 2 patients with unexpected responses to rocuronium, despite being otherwise unremarkable. Quantitative neuromuscular monitoring provided clear documentation of the events, providing illustrations of these atypical responses.
May 23, 2017: A & A Case Reports
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
#5
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/28485386/monitoring-rate-and-predictability-of-intraoperative-monitoring-in-patients-with-intradural-extramedullary-and-epidural-metastatic-spinal-tumors
#6
H Kang, H S Gwak, S H Shin, M K Woo, I H Jeong, H Yoo, J W Kwon, S H Lee
STUDY DESIGN: Single-center retrospective study. OBJECTIVES: To evaluate the monitoring rate, sensitivity and specificity of intraoperative monitoring (IOM) during removal of intradural extramedullary (IDEM) or epidural metastatic spinal tumors. Also, to assess the efficacy of monitoring somatosensory-evoked potentials (SSEP) when motor-evoked potentials (MEP) are not measurable. SETTING: The Neuro-Oncology Clinic, National Cancer Center, Korea...
May 9, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28448298/anesthetic-consideration-for-neuromuscular-diseases
#7
Jeffery A Katz, Glenn S Murphy
PURPOSE OF REVIEW: The aim of this review is to examine data relating to perioperative management of the patient with neuromuscular disorders RECENT FINDINGS: Patients with pre-existing neuromuscular disorders are at risk for a number of postoperative complications that are related to anesthetic drugs that are administered intraoperatively. Careful preoperative assessment is necessary to reduce morbidity and mortality. In particular, the risk of postoperative respiratory failure and need for long-term ventilation should be reviewed with patients...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28433839/the-diagnostic-accuracy-of-evoked-potential-monitoring-techniques-during-intracranial-aneurysm-surgery-for-predicting-postoperative-ischemic-damage-a-systematic-review-and-meta-analysis
#8
REVIEW
Benjamin Thomas, Dongsheng Guo
OBJECTIVE: To investigate the diagnostic accuracy of various evoked potential monitoring techniques in predicting postoperative neurologic deficit in intracranial aneurysm surgery. METHODS: A literature search of the MEDLINE, Embase, and Cochrane databases was conducted for English language articles published between March 31, 1983 and March 31, 2016. Original studies that reported the use of evoked potential monitoring during intracranial aneurysm surgery in predicting postoperative neurologic damage were selected, and their relevant reference lists were hand searched...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28351905/comparison-of-cisatracurium-versus-atracurium-in-early-ards
#9
Leanne Moore, Charles Joseph Kramer, Sophie Delcoix-Lopes, Ariel M Modrykamien
BACKGROUND: Administration of cisatracurium in severe ARDS decreases in-hospital mortality. Whether clinical outcomes are cisatracurium-specific or related with all neuromuscular blockers is unknown. This study aimed to compare outcomes in severe ARDS patients treated with cisatracurium versus atracurium. METHODS: Patients admitted in ICUs with a diagnosis of severe ARDS and treated with neuromuscular blocking agents within 72 h of diagnosis were included. Subjects treated with cisatracurium versus atracurium were compared...
March 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28351497/a-preferential-delivery-method-to-investigate-direct-neuromuscular-blockade-effect-of-inhaled-anesthetics-on-skeletal-muscle
#10
Ling Ye, Pingliang Yang
Inhaled anesthetics can enhance the effect of neuromuscular blocker, but whether inhaled anesthetics such as sevoflurane have a direct effect on skeletal muscle contractility is unknown. Selectively blocking skeletal muscle may prevent the interference effect of central nervous system. So we decided to evaluate a local application of neuromuscular blocker (NMB) atracurium to prevent the general effect on skeletal muscle. In part 1, sevoflurane (a inhaled anesthetic) minimum alveolar concentrations (MAC) of 1...
April 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28349321/recurrent-laryngeal-nerve-monitoring-and-rocuronium-a-selective-sugammadex-reversal-protocol
#11
Ombeline Empis de Vendin, Denis Schmartz, Laurent Brunaud, Thomas Fuchs-Buder
BACKGROUND: The use of neuromuscular blocking agents may affect intraoperative neuromonitoring during thyroid surgery. A selective neuromuscular recovery protocol was evaluated in a retrospective cohort study during human thyroid neural monitoring surgery. METHODS: One hundred and twenty-five consecutive patients undergoing thyroidectomy with intraoperative neuromonitoring followed a selective neuromuscular block recovery protocol-single intubating dose of rocuronium followed by sugammadex if needed at the first vagal stimulation (V1)...
March 27, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28238585/recovery-from-rocuronium-induced-neuromuscular-block-was-longer-in-the-larynx-than-in-the-pelvic-limb-of-anesthetized-dogs
#12
Daniel M Sakai, Manuel Martin-Flores, Marta Romano, Chia T Tseng, Luis Campoy, Robin D Gleed, Jonathan Cheetham
OBJECTIVE: To determine if neuromuscular monitoring at the pelvic limb accurately reflects neuromuscular function in the larynx after administration of rocuronium in anesthetized dogs. STUDY DESIGN: Prospective experimental study. ANIMALS: Six healthy Beagle dogs. METHODS: Anesthesia was maintained in dogs with isoflurane and a continuous infusion of dexmedetomidine. Rocuronium (0.6 mg kg(-1)) was administered intravenously to induce neuromuscular block...
March 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28235515/case-report-neuromuscular-block-induced-by-rocuronium-following-sugammadex-administration
#13
Tugba Askin, Suheyla Unver, Deniz Oguz, Kubra Kutay
We present a case in which rocuronium was applied for muscle relaxation following the administration of sugammadex. An emergency surgery under general anesthesia was planned for a 43-year-old male patient due to an L1 vertebral corpus and right tibia-fibula shaft fracture. Anesthesia was induced with fentanyl, propofol and lidocaine. After applying only 30mg of the total induction dose of rocuronium, it was learned that the neurological examination should be controlled again from the surgeon because of the controversial of the neurological deficit...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28216703/effects-of-avoiding-neuromuscular-blocking-agents-during-maintenance-of-anaesthesia-on-recovery-characteristics-in-patients-undergoing-craniotomy-for-supratentorial-lesions-a-randomised-controlled-study
#14
Ruchi A Jain, Anita N Shetty, Shrikanta P Oak, Anjana S Wajekar, Madhu B Garasia
BACKGROUND AND AIMS: Neuromuscular blocking agents have been one of the cornerstones of anaesthesia. With the advent of newer surgical, anaesthetic and neurological monitoring techniques, their utility in neuroanaesthesia practice seems dispensable. The aim of this prospective, comparative, randomised study was to determine whether neuromuscular blocking agents are required in patients undergoing supratentorial surgery when balanced anaesthesia with desflurane, dexmedetomidine and scalp block is used...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28183581/chemotherapy-alters-cisatracurium-induced-neuromuscular-blockade-characteristics-a-prospective-cohort-study
#15
Amir Poya Zanjani, Maziar Maghsoudloo, Jalil Makarem, Fahimeh Farokhnia, Morteza Fazli, Zahid Hussain Khan
STUDY OBJECTIVE: To compare the characteristics of NMDR induced muscle paralysis in breast cancer patients with and without a history of recent chemotherapy with cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) regimen. DESIGN: This is a non-randomized prospective cohort study. SETTING: Operating room of a university-affiliated teaching hospital. PATIENTS: Out of a total of 50 patients who had undergone mastectomy, 22 patients were allocated to the "Chemo group" and 28 patients to the "Non-Chemo group", based on a valid history of recent chemotherapy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183558/frequency-of-inadequate-neuromuscular-blockade-during-general-anesthesia
#16
Timur Dubovoy, Amy M Shanks, Scott Devine, Sachin Kheterpal
STUDY OBJECTIVE: We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). DESIGN: Retrospective observational study using electronic health record data. SETTING: Operating room in a tertiary care academic hospital. PATIENTS: A total of 129,209 adult patients with American Society of Anesthesiologists physical status 1 to 5 undergoing general anesthesia in an outpatient or inpatient setting who received nondepolarizing NMB...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28164269/anaesthetic-hypersensitivity-reactions-in-france-between-2011-and-2012-the-10th-gerap-epidemiologic-survey
#17
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/28044330/conceptual-and-technical-insights-into-the-basis-of-neuromuscular-monitoring
#18
REVIEW
M Naguib, S J Brull, K B Johnson
Unrecognised postoperative residual neuromuscular block remains a frequent occurrence in recovery rooms. Evidence indicates that current practice continues to perpetuate the status quo, in which 10-40% of patients experience postoperative residual weakness. A departure from the current practice requires small efforts on the clinicians' part. This review addresses several selected core questions regarding neuromuscular blockade monitoring and provides a framework to rationally discuss and develop basic guidelines for the use of neuromuscular blocking agents in patient care...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28030444/impact-of-reversal-strategies-on-the-incidence-of-postoperative-residual-paralysis-after-rocuronium-relaxation-without-neuromuscular-monitoring-a-partially-randomised-placebo-controlled-trial
#19
Réka Nemes, Béla Fülesdi, Adrienn Pongrácz, László Asztalos, Zoltán Szabó-Maák, Szabolcs Lengyel, Edömér Tassonyi
BACKGROUND: Electronic neuromuscular monitoring is not widely used to determine either the reversal requirements for neuromuscular block before extubation of the trachea, or to determine if there is any subsequent postoperative residual neuromuscular block (PORNB). OBJECTIVES: To investigate the incidence of PORNB using acceleromyography after spontaneous recovery of rocuronium-induced block and to compare this with the administration of sugammadex, neostigmine or a placebo...
December 26, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28013329/effects-of-neuromuscular-blockers-on-transpulmonary-pressures-in-moderate-to-severe-acute-respiratory-distress-syndrome
#20
RANDOMIZED CONTROLLED TRIAL
Christophe Guervilly, Magali Bisbal, Jean Marie Forel, Malika Mechati, Samuel Lehingue, Jeremy Bourenne, Gilles Perrin, Romain Rambaud, Melanie Adda, Sami Hraiech, Elisa Marchi, Antoine Roch, Marc Gainnier, Laurent Papazian
PURPOSE: To investigate whether neuromuscular blocking agents (NMBA) exert beneficial effects in acute respiratory distress syndrome (ARDS) by reason of their action on respiratory mechanics, particularly transpulmonary pressures (P L). METHODS: A prospective randomised controlled study in patients with moderate to severe ARDS within 48 h of the onset of ARDS. All patients were monitored by means of an oesophageal catheter and followed up for 48 h. Moderate ARDS patients were randomised into two groups according to whether they were given a 48-h continuous infusion of cisatracurium besylate or not (control group)...
March 2017: Intensive Care Medicine
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