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"Cisatracurium" AND "Emergency"

Jian-Ping Wu, Jian-Xiong An, Xiao-Yan Qian, Yong Wang
We report the successful treatment of idiopathic intractable hiccups with cisatracurium under intravenous general anesthesia. The patient had a history of hiccups for 19 years that were refractory to a variety of treatments. When his hiccups were accompanied by vomiting, insomnia, shortness of breath, and poor oral intake for 9 days, he sought relief. We administered a nondepolarizing muscle relaxant, cisatracurium, during total intravenous anesthesia, to stop the hiccups. The duration of the anesthetic was determined by the time it took for the patient to recover from the neuromuscular blockade without reversal the cisatracurium...
April 1, 2018: A&A Practice
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
Khaled Elbahrawy, Alaa El-Deeb
BACKGROUND: Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis, immediate anticoagulation, and intervention to restore mesenteric blood flow adequately. AIMS: To investigate the effect of rectus sheath block (RSB) for postoperative analgesia in patients with mesenteric vascular occlusion. SETTINGS AND DESIGN: Forty patients with mesenteric vascular occlusion, American Society of Anesthesiologists physical status I or II or III, scheduled for laparotomy were enrolled in this study...
September 2016: Anesthesia, Essays and Researches
Susan R Wilcox, Michael Ries, Ted A Bouthiller, E Dean Berry, Travis L Dowdy, Sharon DeGrace
Critical care transport (CCT) teams are specialized transport services, comprised of highly trained paramedics, nurses, and occasionally respiratory therapists, offering an expanded scope of practice beyond advanced life support (ALS) emergency medical service teams. We report 4 cases of patients with severe acute respiratory distress syndrome from influenza in need of extracorporeal membrane oxygenation evaluation at a tertiary care center, transported by ground. Our medical center did not previously have a ground CCT service, and therefore, in these cases, a physician and/or a respiratory therapist was sent with the paramedic team...
February 2017: Journal of Intensive Care Medicine
Sabrina De Winter, Koen Bronselaer, Peter Vanbrabant, Bart Blanchaert, Marwa F Mansour, Daniele Brandolisio, Stijn De Jonge, Peter Slaets, Paul Sas, Ann Van Schepdael, Isabel Spriet
OBJECTIVE: Transportation by air exposes drugs used in emergency medical services to vibrations. The aim of the study was to determine whether or not vibrations caused by a helicopter induce the degradation of 5 drugs used in this setting. METHODS: A longitudinal study in an operating medical helicopter along with a worst case was conducted. The studied drugs were 3 drugs labeled for refrigeration (cisatracurium, lorazepam, and succinylcholine) and 2 albumin solutions (human albumin 4% and 20%)...
July 2016: Air Medical Journal
Zhuan Zhang, Dong-sheng Zhang, Wei Sui, Xu-hong Liu, Luo Zhang, Jian-hong Sun
OBJECTIVE: To compare the effects of different doses of cisatracurium pretreatment on succinylcholine-induced fasciculations. METHODS: 90 patients scheduled for laparoscopic cholecystectomies were equally randomized into three groups to receive pretreatment of 0.005, 0.01, and 0.02 mg/kg cisatracurium, respectively. After the pretreatments, general anesthesia was induced 3.5 minutes later, train-of-four stimulation was monitored 4.5 minutes later, succinylcholine 1...
June 2016: International Journal of Clinical Pharmacology and Therapeutics
Linda V Graudins, Glenn Downey, Thuy Bui, Michael J Dooley
BACKGROUND: Neuromuscular blocking agents (NMBs) are high-risk medications used to facilitate endotracheal intubation and artificial ventilation. In an incident at a metropolitan tertiary referral and teaching public hospital in Australia, a neurosurgical patient became unresponsive at the start of surgery. It was determined that cisatracurium was administered in error in place of midazolam; the patient was ventilated and the emergency surgery continued. Two additional non-operating room (OR) drug-swap cases involving cisatracurium were reported within 12 months of this event, resulting in a comprehensive review of NMB safety...
February 2016: Joint Commission Journal on Quality and Patient Safety
Wei Peng, TieJun Zhang
BACKGROUND: To determine whether continuous intravenous infusion of dexmedetomidine (DEX) can affect the incidence of Emergence Agitation (EA) after general anesthesia in infant undergoing cleft palate repair surgery. METHODS: Forty infants underwent cleft palate repair surgery under general anesthesia were randomly divided into the DEX (D) group and Placebo (P) groups. Patients in group D received continuous intravenous infusion of DEX 0.8 μg · kg-1 · min-1 after the induction...
October 13, 2015: BMC Anesthesiology
Xu-Li Yang, Shu-Hong Dai, Juan Zhang, Jing Zhang, Yan-Jun Liu, Yan Yang, Yu-E Sun, Zheng-Liang Ma, Xiao-Ping Gu
Here we described a case in which a patient underwent emergency laparotomy for acute peritonitis and sigmoid perforation under general anesthesia with a history of heart transplantation. A good knowledge in the physiology of the transplanted heart is critical for effective and safe general anesthesia. We chose etomidate that have a weaker impact on cardiovascular function plus propofol for induction, and propofol plus cisatracurium for maintenance with intermittently analgesics and vasoactive drugs to facilitate the anesthesia...
2015: International Journal of Clinical and Experimental Medicine
Giovani de Figueiredo Locks, Ismar Lima Cavalcanti, Nadia Maria Conceição Duarte, Rafael Martins da Cunha, Maria Cristina Simões de Almeida
The objective of this study was to evaluate how Brazilian anesthesiologists are using neuromuscular blockers, focusing on how they establish the diagnosis of postoperative residual curarization and the incidence of complications associated with the use of neuromuscular blockers. A questionnaire was sent to anesthesiologists inviting them to participate in the study. The online data collection remained open from March 2012 to June 2013. During the study period, 1296 responses were collected. Rocuronium, atracurium, and cisatracurium were the main neuromuscular blockers used in cases of elective surgery...
September 2015: Brazilian Journal of Anesthesiology
Giovani de Figueiredo Locks, Ismar Lima Cavalcanti, Nadia Maria Conceição Duarte, Rafael Martins da Cunha, Maria Cristina Simões de Almeida
The objective of this study was to evaluate how Brazilian anesthesiologists are using neuromuscular blockers (NMB), focusing on how they establish the diagnosis of postoperative residual curarization and the incidence of complications associated with the use of NMB. A questionnaire was sent to anesthesiologists inviting them to participate in the study. The online data collection remained open from March 2012 to June 2013. During the study period, 1296 responses were collected. Rocuronium, atracurium, and cisatracurium were the main neuromuscular blockers used in cases of elective surgery...
September 2015: Revista Brasileira de Anestesiologia
Michael J Klein, Timothy I Carter, Michael C Smith, Jonathan Wong, Gainosuke Sugiyama
Management of anemic patients refusing blood transfusion remains challenging. Concomitant coronary artery disease further complicates management. We sought to decrease the likelihood of cardiac events by employing hypothermia and neuromuscular blockade, in addition to limited phlebotomy, in a critically anemic Jehovah's Witness patient following emergent colectomy. The patient's hemoglobin concentrations were trended with serial blood gases. Neuromuscular blockade was instituted with cisatracurium, followed by hypothermia to a target of 32°C...
2014: Journal of Surgical Case Reports
Farhad Solatpour, Houman Teymourian, Seyed Amir Mohajerani, Fatemeh Hoseinzadegan Shirazi, Saran Lotfollah Zadeh, Maryam Baikpour, Razie Amraei
BACKGROUND: Postoperative sore throat is a common complication of endotracheal intubation and can lead to dissatisfaction after surgery. Airway management has the strongest influence on the incidence of sore throat and improving endotracheal intubating conditions can reduce this complaint. Type of induction agent used during anesthesia can contribute to variances in the degree of post-operative sore throat. OBJECTIVES: We aimed to compare the incidence of postoperative sore throat after rapid sequence induction with Succinylcholine and high dose Cisatracurium...
August 2014: Anesthesiology and Pain Medicine
Gonul Olmez, Mehmet Ali Ozyilmaz, Ali Menekse
BACKGROUND: Nasotracheal intubation is often necessary in patients undergoingelective or emergency maxillofacial surgery. Previous studies have suggested that the increase in blood pressure after nasotracheal intubation is significantly greater than the increase after orotracheal intubation. Many drugs, including narcotic analgesics, are effective in modifying cardiovascular responses to orotracheal intubation. OBJECTIVE: The effects of remifentanil and alfentanil on the cardiovascularresponses to nasotracheal intubation were compared in healthy patients scheduled to undergo surgery...
July 2005: Current Therapeutic Research, Clinical and Experimental
Sabrina De Winter, Peter Vanbrabant, N T Tuong Vi, Xiaolan Deng, Isabel Spriet, Ann Van Schepdael, Jean-Bernard Gillet
STUDY OBJECTIVE: The aim of this study is to determine the content of 5 important emergency medical services (EMS) drugs after being stored at the recommended refrigerated temperature, room temperature, or in an emergency physician transport vehicle operating under real-world working conditions. METHODS: Adrenaline hydrochloride, cisatracurium besylate, lorazepam, methylergonovine maleate, and succinylcholine chloride were stored for 1 year under the 3 conditions...
October 2013: Annals of Emergency Medicine
Julia Warr, Zoé Thiboutot, Louise Rose, Sangeeta Mehta, Lisa D Burry
OBJECTIVE: To summarize literature describing use of neuromuscular blocking agents (NMBAs) for common critical care indications and provide a review of NMBA pharmacology, pharmacokinetics, dosing, drug interactions, monitoring, complications, and reversal. DATA SOURCES: Searches of MEDLINE (1975-May 2011), EMBASE (1980-May 2011), and Cumulative Index to Nursing and Allied Health Literature (1981-May 2011) were conducted to identify observational and interventional studies evaluating the efficacy or safety of NMBAs for management of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), status asthmaticus, elevated intracranial pressure (ICP), and therapeutic hypothermia...
September 2011: Annals of Pharmacotherapy
R Chabanne, S Colomb, D Gonzalez, S Perbet
OBJECTIVE: To evaluate the use of neuromuscular blocking agents (NMBA) in the French adult Prehospital Emergency Medical Services (PEMS). STUDY DESIGN: Telephone survey of practices. MATERIALS AND METHODS: A survey was conducted from April to July 2009 in every PEMS of the South-East of France. A PEMS physician by center was interviewed using a standardized quiz including demographic data, methods of anesthetic induction, use of NMBA and succinylcholine...
September 2011: Annales Françaises D'anesthèsie et de Rèanimation
P Aceto, V Perilli, E Vitale, L Sollazzi
In this case report, we describe an accentuation of a pre-existing anisocoria shortly after tracheal intubation in a patient undergoing thyroidectomy. A 45-yr-old female patient with unequal pupillary diameter (right 2 mm > than left) and decreased light reflex in the right eye--due to a previous eye trauma--was scheduled for thyroidectomy because of multinodular goiter. Anesthesia was induced with propofol 2,5 mg/kg, fentanyl 3 mcg/kg and cisatracurium 0.15 mcg/kg. Immediately after tracheal intubation, examination of the right eye revealed a markedly dilated pupil (8 mm) which was nonreactive to direct and consensual light reflex...
February 2011: European Review for Medical and Pharmacological Sciences
José Costa, Dalva Maria Carvalho Mendes, José Eduardo de Oliveira Lobo, Adriana Barrozo Ribeiro Furuguem, Gabriel Gilberto Santos
BACKGROUND AND OBJECTIVES: Anesthesia for pregnant patients is a challenge to the anesthesiologist because of the risks for mother and fetus. There are many complications described by the literature, such as fetal malformations, premature birth, maternal hemodynamic instability and even fetal death. The objective here is to show a 28 weeks pregnant patient submitted to partial laryngectomy under total intravenous general anesthesia with propofol, remifentanil and cisatracurium. CASE REPORT: Patient 29 years, 59 kg, primigravida of 28 weeks with previous diagnosis of epidermoid carcinoma close to the right vocal chord, scheduled for laryngectomy...
April 2005: Revista Brasileira de Anestesiologia
Deeptankar Demazumder, James P Dilger
Detailed information about the ligand-binding site of nicotinic acetylcholine receptors has emerged from structural and mutagenesis experiments. However, these approaches provide only static images of ligand-receptor interactions. Kinetic measurements of changes in protein function are needed to develop a more dynamic picture. Previously, we measured association and dissociation rate constants for competitive inhibition of current through embryonic muscle acetylcholine receptor channels at 25 degrees C. Little is known about competitive antagonism at physiological temperatures...
February 15, 2008: Journal of Physiology
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