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monitoring neuromuscular block

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https://www.readbyqxmd.com/read/27909595/effect-of-smoking-on-reversing-neuromuscular-block
#1
Ömür Öztürk, Gülbin Yalçın Sezen, Handan Ankaralı, Onur Özlü, Yavuz Demiraran, Hakan Ateş, Burhan Dost
OBJECTIVE: Rocuronium is a non-depolarising, intermediate-acting, monoquaternary amino steroid and was brought into clinical use as a potentially ideal muscle relaxant. Post-operative residual curarisation (PORC) results from the prolonged effects of non-depolarising neuromuscular blocking agents. This is a common problem and seriously affects patient safety. No recent study has investigated the effects of sugammadex on smokers, which is often used to restore neuromuscular block and avoid PORC...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27871583/sugammadex-given-for-rocuronium-induced-neuromuscular-blockade-in-infants-a-retrospect%C3%A4-ve-study
#2
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
https://www.readbyqxmd.com/read/27871520/cisatracurium-and-rocuronium-associated-residual-neuromuscular-dysfunction-under-intraoperative-neuromuscular-monitoring-and-postoperative-neostigmine-reversal-a-single-blind-randomized-trial
#3
Paolo Feltracco, Tommaso Tonetti, Stefania Barbieri, Anna Chiara Frigo, Carlo Ori
BACKGROUND: Postoperative residual neuromuscular blockade (RNMB) is a common complication in the postanesthesia care unit (PACU), but also one of the most controversial issues. Many studies and trials demonstrated that some methods and techniques can reduce the incidence and the extent of the phenomenon. STUDY OBJECTIVE: To determine the incidence of RNMB in the PACU at standardized times after extubation with the implementation of a protocol of careful neuromuscular blockade management...
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
#4
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/27832572/the-influence-of-introducing-unrestricted-access-to-sugammadex-and-quantitative-neuromuscular-monitors-on-the-incidence-of-residual-neuromuscular-block-at-a-tertiary-teaching-hospital-an-audit-of-real-life
#5
J I Milne, C S Ong, J S Ong, K C Cheung, A A Schauer, S B Buttar, T Ledowski
No abstract text is available yet for this article.
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27828786/the-effect-of-prior-tetanic-stimulation-on-train-of-four-monitoring-in-paediatric-patients-a-randomised-open-label-controlled-trial
#6
Ricardo V Carlos, Hans Donald de Boer, Marcelo Luis Abramides Torres, Maria José Carvalho Carmona
BACKGROUND: In clinical research, neuromuscular monitoring must present a stable response for a period of 2 to 5 min before administration of a neuromuscular blocking agent. The time required to reach this stable response may be shortened by applying a 5-s tetanic stimulus. OBJECTIVES: The aim of this study was to test whether tetanic stimulation interferes with onset and recovery times after a single dose of rocuronium 0.6 mg kg followed by spontaneous recovery...
November 8, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27820709/current-status-of-neuromuscular-reversal-and-monitoring-challenges-and-opportunities
#7
Sorin J Brull, Aaron F Kopman
Postoperative residual neuromuscular block has been recognized as a potential problem for decades, and it remains so today. Traditional pharmacologic antagonists (anticholinesterases) are ineffective in reversing profound and deep levels of neuromuscular block; at the opposite end of the recovery curve close to full recovery, anticholinesterases may induce paradoxical muscle weakness. The new selective relaxant-binding agent sugammadex can reverse any depth of block from aminosteroid (but not benzylisoquinolinium) relaxants; however, the effective dose to be administered should be chosen based on objective monitoring of the depth of neuromuscular block...
November 7, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27818334/neuromuscular-blockade-in-the-21-st-century-management-of-the-critically-ill-patient
#8
REVIEW
Julian deBacker, Nicholas Hart, Eddy Fan
Neuromuscular blockings agents (NMBAs) have a controversial role in the ventilatory and medical management of critical illness. The clinical concern surrounding NMBA-induced complications stems from evidence presented in the 2002 clinical practice guidelines, but new evidence from subsequent randomized trials and studies provides a more optimistic outlook about the application of NMBAs in the intensive care unit (ICU). Furthermore, changes in the delivery of critical care such as protocolized care pathways, minimizing or interrupting sedation, increased monitoring techniques, and overall improvements in reducing immobility have created a modern, 21st century ICU environment whereby NMBAs may be administered safely...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27798767/practical-management-of-anaesthesia-in-the-elderly
#9
Camilla Strøm, Lars Simon Rasmussen, Jacob Steinmetz
The elderly population is rapidly growing and particularly diverse. Ageing leads to reduced organ function and a decline in physiologic reserve. Elderly patients are characterised by great inter-individual variability in physiological function with a high prevalence of chronic disease. In general, older patients have a higher risk of postoperative adverse outcomes, and frailty is a very important risk factor. This review article aims to provide a practical guide to anaesthetic management of the elderly surgical patient...
October 31, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27755128/residual-neuromuscular-blockade-management-and-impact-on-postoperative-pulmonary-outcome
#10
Thomas Fuchs-Buder, Réka Nemes, Denis Schmartz
PURPOSE OF REVIEW: To revise the current literature on concepts for neuromuscular block management. Moreover, consequences of incomplete neuromuscular recovery on patients' postoperative pulmonary outcome are evaluated as well. RECENT FINDINGS: The incidence of residual paralysis may be as high as 70% and even small degrees of residual paralysis may have clinical consequences. Neostigmine should not be given before return of the fourth response of the train-of-four-stimulation and no more than 40-50 μg/kg should be given...
December 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27755068/clinical-practice-guidelines-for-sustained-neuromuscular-blockade-in-the-adult-critically-ill-patient
#11
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27736241/to-jump-or-cycle-monitoring-neuromuscular-function-in-rugby-union-players
#12
Gregory Roe, Joshua Darrall-Jones, Kevin Till, Padraic Phibbs, Dale Read, Jonathon Weakley, Ben Jones
PURPOSE: The purpose of this study was to evaluate changes in performance of a 6-second cycle ergometer test (CET) and countermovement jump (CMJ) during a 6-week training block in professional rugby union players. METHODS: Twelve young professional rugby union players performed two CET and CMJ on the first and fourth morning of every week prior to the commencement of daily training during a 6-week training block. Standardised changes in the highest score of two CET and CMJ efforts were assessed using linear mixed modelling and magnitude-based inferences...
October 13, 2016: International Journal of Sports Physiology and Performance
https://www.readbyqxmd.com/read/27698008/phlebitis-as-a-consequence-of-peripheral-intravenous-administration-of-cisatracurium-besylate-in-critically-ill-patients
#13
Annelijn M Meeder, Marijke S van der Steen, Annemieke Rozendaal, Arthur R H van Zanten
This case report series describes 3 cases of cisatracurium besylate associated phlebitis after an infusion period of 14-20 hours. No similar cases have been reported in the literature. Association of phlebitis with another neuromuscular blocking agent, atracurium, has been described in the literature. The acidity of atracurium is thought to be the main cause. It is recommended that atracurium is administered only via central venous catheters when indicated to infuse over prolonged periods of time due to the acidity...
October 3, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27555126/recovery-of-laryngeal-nerve-function-with-sugammadex-after-rocuronium-induced-profound-neuromuscular-block
#14
Vittorio Pavoni, Lara Gianesello, Cristiana Martinelli, Andrew Horton, Alessandra Nella, Gabriele Gori, Martina Simonelli, Giuseppe De Scisciolo
STUDY OBJECTIVE: The aim of this study was to evaluate the efficacy of sugammadex in reversing profound rocuronium-induced neuromuscular block at the laryngeal adductor muscles using motor-evoked potentials (mMEPs). DESIGN: A prospective observational study. SETTING: University surgical center. PATIENTS: Twenty patients with American Society of Anesthesiologists physical class I-II status who underwent propofol-remifentanil anesthesia for the surgery of the thyroid gland...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27549387/the-neuromuscular-effects-of-rocuronium-under-sevoflurane-remifentanil-or-propofol-remifentanil-anesthesia-a-randomized-clinical-comparative-study-in-an-asian-population
#15
Sangseok Lee, Young Jin Ro, Won Uk Koh, Tomoki Nishiyama, Hong-Seuk Yang
BACKGROUND: We conducted a prospective, randomized, multicenter study to evaluate the differences in the blocking effect of different doses of rocuronium between sevoflurane- or propofol-remifentanil anesthesia in an Asian population. METHODS: A total of 368 ASA I-II patients was enrolled. Anesthesia was induced with 2.0 mg/kg propofol and 0.1 μg/kg/min remifentanil (TIVA) or 5.0 vol.% sevoflurane with 0.1 μg/kg/min remifentanil (SEVO). Tracheal intubation was facilitated at 180 s after the administration of rocuronium at 0...
August 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27545305/pharmacokinetics-and-pharmacodynamics-of-rocuronium-in-young-adult-and-elderly-patients-undergoing-elective-surgery
#16
Renan M Varrique, Gabriela R Lauretti, Julia A Matsumoto, Vera L Lanchote, Natalia V de Moraes
OBJECTIVE: To evaluate the impact of advanced age on rocuronium kinetic disposition in ASA I-III patients undergoing elective surgeries. METHODS: Young adult (20-50 years, n = 15) and elderly patients (65-85 years, n = 14) submitted to surgery under general anaesthesia were investigated. All patients were induced with individual intravenous doses of midazolam, rocuronium, fentanyl and propofol. Rocuronium-induced neuromuscular block was monitored by train of four stimulations of the adductor muscle of the thumb on the ulnar nerve...
August 21, 2016: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/27524943/qualitative-neuromuscular-monitoring-how-to-optimize-the-use-of-a-peripheral-nerve-stimulator-to-reduce-the-risk-of-residual-neuromuscular-blockade
#17
Stephan R Thilen, Sanjay M Bhananker
This review provides recommendations for anesthesia providers who may not yet have quantitative monitoring and sugammadex available and thus are providing care within the limitations of a conventional peripheral nerve stimulator (PNS) and neostigmine. In order to achieve best results, the provider needs to understand the limitations of the PNS. The PNS should be applied properly and early. All overdosing of neuromuscular blocking drugs should be avoided and the intraoperative neuromuscular blockade should be maintained only as deep as necessary...
2016: Current Anesthesiology Reports
https://www.readbyqxmd.com/read/27484887/sugammadex-facilitates-early-recovery-after-surgery-even-in-the-absence-of-neuromuscular-monitoring-in-patients-undergoing-laryngeal-microsurgery-a-single-center-retrospective-study
#18
Eui-Seok Park, Byung Gun Lim, Won-Joon Lee, Il Ok Lee
BACKGROUND: In many countries, routine clinical anaesthesia does not always involve neuromuscular monitoring. In these clinical settings, the efficacy and safety of sugammadex use has not yet been confirmed. We investigated the efficacy and safety of sugammadex in the absence of neuromuscular monitoring. METHODS: One hundred and forty patients who underwent laryngeal microsurgery with the use of rocuronium as a neuromuscular blocking agent, without the use of a neuromuscular monitoring device, were retrospectively investigated...
2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27418846/the-use-of-sugammadex-for-bariatric-surgery-analysis-of-recovery-time-from-neuromuscular-blockade-and-possible-economic-impact
#19
Edoardo De Robertis, Geremia Zito Marinosci, Giovanni Marco Romano, Ornella Piazza, Michele Iannuzzi, Fabrizio Cirillo, Stefania De Simone, Giuseppe Servillo
BACKGROUND: Neuromuscular block (NMB) monitoring and use of reversal agents accelerate the recovery time and improve the workflow in the operating room. We aimed to compare recovery times after sugammadex or neostigmine administration, and estimate the time spent in operating theater and the possible economic impact of a faster recovery, in morbidly obese patients undergoing bariatric surgery. METHODS: We conducted a retrospective study that analyzed data from records of morbidly obese patients (body mass index >40 kg/m(2)) undergoing elective laparoscopic bariatric surgery in which sugammadex or neostigmine were used to reverse NMB...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27413175/total-intravenous-anaesthesia-using-propofol-and-sufentanil-allows-controlled-long-term-ventilation-in-rabbits-without-neuromuscular-blocking-agents
#20
Verena Reupke, Karoline Walliser, Thorsten Perl, Sarah Kimmina, Anke Schraepler, Michael Quintel, Nils Kunze-Szikszay
The aim of this study was to evaluate a total intravenous anaesthesia (TIVA) protocol using propofol and sufentanil without neuromuscular blocking agents (NBAs) for a non-recovery lung pathology study in rabbits including 10 h of pressure-controlled ventilation. TIVA was started with 20 mg/kg/h propofol and 0.5 µg/kg/h sufentanil. The depth of anaesthesia was assessed by reflex testing and monitoring of spontaneous movements or respiratory efforts. Vital parameters were monitored to assess the effects of the TIVA protocol...
July 13, 2016: Laboratory Animals
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