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https://www.readbyqxmd.com/read/29121289/association-between-intraoperative-non-depolarising-neuromuscular-blocking-agent-dose-and-30-day-readmission-after-abdominal-surgery
#1
T Thevathasan, S L Shih, K C Safavi, D L Berger, S M Burns, S D Grabitz, R S Glidden, R D Zafonte, M Eikermann, J C Schneider
Background: We hypothesised that intraoperative non-depolarising neuromuscular blocking agent (NMBA) dose is associated with 30-day hospital readmission. Methods: Data from 13,122 adult patients who underwent abdominal surgery under general anaesthesia at a tertiary care hospital were analysed by multivariable regression, to examine the effects of intraoperatively administered NMBA dose on 30-day readmission (primary endpoint), hospital length of stay, and hospital costs...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29116244/delivery-of-neostigmine-and-glycopyrrolate-by-iontophoresis-a-nonrandomized-study-in-individuals-with-spinal-cord-injury
#2
Mark A Korsten, Brian L Lyons, Miroslav Radulovic, Tradd M Cummings, Gautam Sikka, Kamaldeep Singh, Anton Sabiev, Ann M Spungen, William A Bauman
STUDY DESIGN: Phase I Clinical Trial. OBJECTIVES: In this proof-of-principle study, the effectiveness and safety of transdermal administration of neostigmine/glycopyrrolate to elicit a bowel movement was compared to intravenous administration in patients with spinal cord injury. SETTING: James J. Peters Veterans Affairs Medical Center (Bronx, NY). METHODS: Individuals were screened for responsiveness (Physical Response) to intravenous neostigmine (0...
November 8, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29111148/effects-of-opioid-and-nonopioid-analgesics-on-canine-wheal-formation-and-cultured-human-mast-cell-degranulation
#3
Eric Schmidt-Rondon, Zhenping Wang, Shelle A Malkmus, Anna Di Nardo, Keith Hildebrand, Linda Page, Tony L Yaksh
Mast cell (MC) degranulation has been implicated in the side effect profile of a variety of clinically useful agents. Thus, after intrathecal delivery, formation of space-occupying, meningeally-derived masses may be related to local MC degranulation. We systematically characterized degranulating effects of opioid and nonopioid analgesics on cutaneous flares in the dog and in primary human MC (hMC) cultures. METHODS: Dogs were anesthetized with IV propofol and received intradermal (ID) injections (50μL)...
October 27, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/29109645/neostigmine-induced-coronary-artery-spasm-a-case-report-and-literature-review
#4
Shimon Kolker, Dan Tzivoni, David Rosenmann, Shmuel Meyler, Alexander Ioscovich
Neostigmine is a cholinesterase inhibitor which does not cross the blood brain barrier and a commonly used for reversal of nondepolarizing muscle relaxants. In the following case report, we present a patient who developed coronary artery spasm, after the administration of repeated doses of neostigmine. Ours is the first case to demonstrate such a longstanding coronary artery vasospasm that lasted several hours in response to neostigmine, resulting in myocardial damage and left ventricular dysfunction. We would like to draw the attention of the anesthesiologists to this rare effect that may lead to perioperative cardiac complications...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29107209/phkv-a-toxin-isolated-from-the-spider-venom-induces-antinociception-by-inhibition-of-cholinesterase-activating-cholinergic-system
#5
Flavia Karine Rigo, Mateus Fortes Rossato, Gabriela Trevisan, Samira Dal-Toé De Prá, Rafael Porto Ineu, Mariane Bernardo Duarte, Célio José de Castro Junior, Juliano Ferreira, Marcus Vinicius Gomez
BACKGROUND AND AIMS: Cholinergic agents cause antinociception by mimicking the release of acetylcholine (ACh) from spinal cholinergic nerves. PhKv is a peptide isolated from the venom of the armed spider Phoneutria nigriventer. It has an antiarrythmogenic activity that involves the enhanced release of acetylcholine. The aim of this study was to investigate whether PhKv had an antinociceptive action in mice. METHODS: Male albino Swiss mice (25-35g) were used in this study...
October 26, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29095176/sugammadex-for-neuromuscular-blockade-reversal
#6
Michelle R Papathanas, Alley Killian
Postoperative residual neuromuscular blockade is associated with an increased risk of respiratory insufficiency, aspiration, and potential pulmonary complications. The standard of care for reversal of residual block centers on anticholinesterases such as neostigmine. However, these medications provide inconsistent or inadequate effect while being associated with potentially severe adverse effects. Sugammadex, a modified γ-cyclodextrine compound, is a recently approved agent for the reversal of blockade with aminosterodial neuromuscular blockers...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29092846/bdnf-overexpression-in-bladder-induces-neuronal-changes-to-mediate-bladder-overactivity
#7
Mahendra Kashyap, Subrata Pore, William C de Groat, Christopher Chermansky, Naoki Yoshimura, Pradeep Tyagi
Elevated levels of brain derived neurotrophic factor (BDNF) in urine of overactive bladder (OAB) patients support the association of BDNF with OAB symptoms, but the causality is not known. Here, we investigated the functionality of BDNF overexpression in rat bladder following bladder wall transfection of either BDNF or luciferase transgenes (10µg). A week after transfection, BDNF overexpression in bladder tissue and elevation of urine BDNF levels was observed together with increased transcript of BDNF, its cognate receptors (TrkB & p75NTR) and downstream PLCγ isoforms in bladder...
November 1, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29090263/respiratory-events-with-sugammadex-vs-neostigmine-following-laparoscopic-sleeve-gastrectomy-a-prospective-pilot-study-assessing-neuromuscular-reversal-strategies
#8
Shmuel Evron, Yuri Abelansky, Tiberiu Ezri, Alexander Izakson
Abdominal surgery in obese patients may be associated with pulmonary morbidity, and mortality. Some patients may arrive in the PACU with residual paralysis. The purpose of this study was to find out if there was an association between the type of muscle relaxant reversal agent and the development of postoperative respiratory events in patients undergoing laparoscopic sleeve gastrectomy surgery. METHODS: From September 2012 to February 2013, in a prospective randomized pilot study, two different muscle relaxant reversal agents were administered at the end of surgery in 57 patients undergoing laparoscopic sleeve gastrectomy: sugammadex 2 mg/kg (32 patients) vs...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29066245/effects-of-neostigmine-or-edrophonium-on-force-of-contraction-when-administered-at-a-train-of-four-ratio-of-0-9-in-anesthetized-dogs
#9
Marta Romano, Manuel Martin-Flores, Daniel M Sakai, Chia T Tseng, Luis Campoy, Robin D Gleed
OBJECTIVE: Anticholinesterase drugs may produce paradoxical neuromuscular block when administered at shallow levels of neuromuscular block. The objective of this study was to evaluate the effects of neostigmine and edrophonium when administered at near-complete reversal from nondepolarizing block in anesthetized dogs. STUDY DESIGN: Incomplete crossover, randomized, blinded experimental study. ANIMALS: A total of 12 Beagle dogs. METHODS: Each dog was anesthetized twice with propofol and maintained with isoflurane and dexmedetomidine...
August 3, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29042841/bradycardia-in-a-pediatric-heart-transplant-recipient-is-it-the-sugammadex
#10
Adele King, Aymen Naguib, Joseph D Tobias
Sugammadex is a novel pharmacologic agent that is used to selectively reverse the effects of the neuromuscular blocking agents rocuronium and vecuronium. Various advantages have been reported when comparing its reversal of neuromuscular blockade to that achieved with acetylcholinesterase inhibitors (neostigmine). In heart transplant recipients, bradycardia may occur following the administration of acetylcholinesterase inhibitors, due to the denervation of the heart. Theoretically, the combination of rocuronium and sugammadex could be advantageous in this clinical scenario to avoid the potential bradycardia resulting from neostigmine administration...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29023733/tonic-inhibition-of-brown-adipose-tissue-sympathetic-nerve-activity-via-muscarinic-acetylcholine-receptors-in-the-rostral-raphe-pallidus
#11
Ellen Paula Santos da Conceição, Christopher J Madden, Shaun F Morrison
We sought to determine if body temperature and energy expenditure are influenced by a cholinergic input to neurons in the rostral raphe pallidus (rRPa), the site of sympathetic premotor neurons controlling brown adipose tissue (BAT) thermogenesis. Nanoinjections of the muscarinic acetylcholine receptor (mAChR) receptor agonist, oxotremorine, or the cholinesterase inhibitor, neostigmine (NEOS), in the rRPa of anaesthetized rats decreased cold-evoked BAT sympathetic nerve activity (SNA, nadirs: -72%, and -95%), BAT temperature (TBAT, -0...
October 10, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29020936/staggering-the-dose-of-sugammadex-lowers-risks-for-severe-emergence-cough-a-randomized-control-trial
#12
Loh P S, M M Miskan, Chin Y Z, R A Zaki
BACKGROUND: Cough on emergence has been reported as a common adverse reaction with sugammadex reversal. We investigated if staggering the dose of sugammadex will reduce emergence cough in a single-center, randomized, double-blinded study. METHODS: A hundred and twenty ASA 1-3 adults were randomly reversed with 1 mg/kg sugammadex prior to extubation followed by another 1 mg/kg immediately after extubation (staggered group), single dose of 2 mg/kg sugammadex (single bolus group) or neostigmine 0...
October 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28975069/the-analgesic-efficacy-of-intrathecal-bupivacaine-and-fentanyl-with-added-neostigmine-or-magnesium-sulphate
#13
Mehrdad Mokaram Dori, Farid Foruzin
BACKGROUND: An appropriate anesthesia duration with minimal side effects and prolonged postoperative analgesia are the ideal characteristics of an intrathecal drug used during spinal anesthesia. Neostigmine and magnesium sulphate have been used as spinal anesthetic additives with narcotics and local anesthetics. OBJECTIVES: This study aimed to assess the analgesic properties of intrathecal neostigmine and magnesium sulphate by adding them to intrathecal bupivacaine-fentanyl...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28972924/incidence-of-complications-in-the-post-anesthesia-care-unit-and-associated-healthcare-utilization-in-patients-undergoing-non-cardiac-surgery-requiring-neuromuscular-blockade-2005-2013-a-single-center-study
#14
Allan W Belcher, Steve Leung, Barak Cohen, Dongsheng Yang, Edward J Mascha, Alparslan Turan, Leif Saager, Kurt Ruetzler
STUDY OBJECTIVE: The use of neuromuscular blockade agents (NMBA), had been associated with significant residual post-operative paralysis and morbidity. There is a lack of clinical evidence on incidence of postoperative complications within the post-anesthesia care unit (PACU) in patients exposed to intraoperative NMBA's. This study aims to estimate the incidence of post-operative complications associated with use of NMBAs and assessing its association with healthcare resource utilization...
September 30, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28966245/long-lasting-inhibitory-effects-of-distigmine-on-recombinant-human-acetylcholinesterase-activity
#15
Keisuke Obara, Daisuke Chino, Yoshio Tanaka
To elucidate the mechanism whereby distigmine, an underactive bladder remedy, potentiates urinary bladder contractions long-lastingly, the inhibition of recombinant human acetylcholinesterase (rhAChE) by distigmine was investigated. A centrifugal ultrafiltration device, Nanosep(®) 10K, was used to separate rhAChE and a bound inhibitor from an unbound inhibitor, reaction substrate, and reaction product. This allowed the same aliquot of rhAChE to be repeatedly assayed for up to 48 h to confirm the long-lasting binding of an inhibitor...
2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28953501/neostigmine-administration-after-spontaneous-recovery-to-a-train-of-four-ratio-of-0-9-to-1-0-a-randomized-controlled-trial-of-the-effect-on-neuromuscular-and-clinical-recovery
#16
Glenn S Murphy, Joseph W Szokol, Michael J Avram, Steven B Greenberg, Torin D Shear, Mark A Deshur, Jessica Benson, Rebecca L Newmark, Colleen E Maher
BACKGROUND: When a muscle relaxant is administered to facilitate intubation, the benefits of anticholinesterase reversal must be balanced with potential risks. The aim of this double-blinded, randomized noninferiority trial was to evaluate the effect of neostigmine administration on neuromuscular function when given to patients after spontaneous recovery to a train-of-four ratio of 0.9 or greater. METHODS: A total of 120 patients presenting for surgery requiring intubation were given a small dose of rocuronium...
September 27, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28913501/acute-poisoning-due-to-ingestion-of-datura-stramonium-a-case-report
#17
Sebastian Daniel Trancă, Robert Szabo, Mihaela Cociş
Datura stramonium (DS) is a widespread annual plant, containing atropine, hyoscyamine, and scopolamine, which can produce poisoning with a severe anticholinergic syndrome. Teenagers ingest the roots, seeds or the entire plant to obtain its hallucinogenic and euphoric effects. We presented the case of a 22 year old male who was admitted to the Emergency Room in a coma after consuming Datura stramonium, 2 hours earlier. The patient presented with fever, tachycardia with right bundle branch block, and urinary retention...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28911287/effect-of-sugammadex-versus-neostigmine-atropine-combination-on-postoperative-cognitive-dysfunction-after-elective-surgery
#18
C Batistaki, M Riga, F Zafeiropoulou, G Lyrakos, G Kostopanagiotou, P Matsota
This study aimed to assess the effects of sugammadex and neostigmine/atropine on postoperative cognitive dysfunction (POCD) in adult patients after elective surgery. A randomised, double-blind controlled trial was carried out on 160 American Society of Anesthesiologists physical status I to III patients who were >40 years. The Mini-Mental State Evaluation, clock-drawing test and the Isaacs Set test were used to assess cognitive function at three timepoints: 1) preoperatively, 2) one hour postoperatively, and 3) at discharge...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28894751/peripheral-inhibitor-of-ache-neostigmine-prevents-the-inflammatory-dependent-suppression-of-gnrh-lh-secretion-during-the-follicular-phase-of-the-estrous-cycle
#19
Andrzej P Herman, Janina Skipor, Agata Krawczyńska, Joanna Bochenek, Karolina Wojtulewicz, Hanna Antushevich, Anna Herman, Kamila Paczesna, Katarzyna Romanowicz, Dorota Tomaszewska-Zaremba
The study was designed to test the hypothesis that the inhibition of acetylcholinesterase (AChE) activity at the periphery by Neostigmine (0.5 mg/animal) will be sufficient to prevent inflammatory dependent suppression of the gonadotropin-releasing hormone (GnRH)/luteinising hormone (LH) secretion in ewes in the follicular phase of the estrous cycle, and this effect will be comparable with the systemic AChE inhibitor, Donepezil (2.5 mg/animal). An immune/inflammatory challenge was induced by peripheral administration of lipopolysaccharide (LPS; 400 ng/kg)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28893807/neostigmine-and-glycopyrronium-a-potential-safe-alternative-for-patients-with-pseudo-obstruction-without-access-to-conventional-methods-of-decompression
#20
Alfred Adiamah, Sarah Johnson, Adrian Ho, James Orbell
Intestinal pseudo-obstruction mimics bowel obstruction. However, on examination, no mechanical cause is identified. This condition will often resolve when managed conservatively, yet in some cases decompression is required to avoid the serious complications of bowel ischaemia and perforation. This is performed endoscopically, and due to the invasive nature and limited access to this service, an alternative treatment option is deemed appealing. Neostigmine has good efficacy in the decompression of pseudo-obstruction but is hindered by its wide side effect profile...
September 11, 2017: BMJ Case Reports
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