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"Vecuronium" AND "Emergency"

Yong-Xing Yao, Jia-Teng Wu, Wei-Liu Zhu, Sheng-Mei Zhu
RATIONALE: Ventilator-associated complications comprise important fatal aetiologies during heart transplantation. Ultra-fast anesthesia might provide the most effective measure to prevent this type of complication. Immediate extubation after heart transplantation (IEAHT) has recently been reported in adult patients. However, IEAHT in children is much more challenging due to limitations in anesthesia protocols. Recently, we managed to perform an ultra-fast anesthesia protocol combined with IEAHT during a heart transplant operation in a child, who had an excellent postoperative outcome...
February 2019: Medicine (Baltimore)
Steven G Schauer, Jason F Naylor, Joseph K Maddry, Denise M Beaumont, Cord W Cunningham, Megan B Blackburn, Michael D April
OBJECTIVES: Airway failures are the second leading cause of potentially preventable death on the battlefield. Improvements in airway management depend on identifying current challenges. We sought to build on previously reported data on prehospital, combat airway management. METHODS: We used a series of emergency department procedure codes to identify patients within the Department of Defense Trauma Registry from January 2007 to August 2016. This is a subanalysis of those with a documented prehospital airway intervention...
December 2018: Southern Medical Journal
Hans D de Boer, Ricardo V Carlos, Sorin J Brull
BACKGROUND: Sugammadex, a γ-cyclodextrin derivative, belongs to a new class of selective relaxant binding agents. Sugammadex was approved 10-years ago by the European medicines agency and today is used in clinical anesthesia and emergency medicine globally. In this review, indications for neuromuscular block, the challenge of neuromuscular monitoring and the practice of under-dosing of sugammadex as a potential cost-saving strategy are discussed. MAIN BODY: Reversal of neuromuscular block is important to accelerate the spontaneous recovery of neuromuscular function...
November 6, 2018: BMC Anesthesiology
A Luckscheiter, M Fischer, W Zink
BACKGROUND AND OBJECTIVE: In 2015 practice management guidelines on prehospital emergency anesthesia in adults were published in Germany. The aim of the present study was to evaluate whether emergency physicians follow these guidelines in daily practice and to assess their level of experience with the use of anesthetic agents. MATERIAL AND METHODS: In an online survey the way of induction of preclinical anesthesia (including preoxygenation time and applied monitoring techniques) was assessed with the help of virtual scenarios based on the guidelines...
January 2018: Der Anaesthesist
Mustafa Azizoglu, Handan Birbicer, Suleyman Memis, Hakan Taşkınlar
Sugammadex is a selective chemical agent that can reverse neuromuscular blockade induced by vecuronium and rocuronium. The aim of this report is to discuss the effectiveness of sugammadex in the reversal of neuromuscular blockade in children younger than 2 years. A 16-month-old boy, weighing 10 kg, was admitted to the pediatric emergency department due to choking, cyanosis, and severe respiratory distress that occurred while he was eating peanuts. In the emergency department, the patient's condition deteriorated, and he went into respiratory arrest...
September 2016: Journal of Clinical Anesthesia
Sonali Ramakant More, Sangeeta Sanjay Dabhade, Balasaheb Baburao Ghongane
INTRODUCTION: Drug cost is essential component of anaesthesia pharmacoeconomics. Recently pharmacoeconomics has emerged to measure, compare and evaluate cost of drug therapy to health system and decide which strategies produce best outcomes for resources allocated. The present study was planned to find utilization of intravenous anaesthetic agents in a tertiary care hospital and to find the pharmacoeconomics related to utilized and un-utilized drug data. MATERIALS AND METHODS: Prospective observational study was conducted for 3 months and 200 cases were recorded undergoing surgical procedures under general anaesthesia only...
November 2015: Journal of Clinical and Diagnostic Research: JCDR
Artur Udelsmann, Priscila Saccomani, Elisabeth Dreyer, Alberto Luiz Cunha da Costa
BACKGROUND AND OBJECTIVES: The status migrainosus is a complication of migraine characterized by severe headache for more than 72h that did not respond to treatment, with risk of stroke and suicide. Researches on treatment are directed to drugs that stimulate GABA receptors; propofol and isoflurane act on sub-GABAa receptors and theoretically could be interesting. The first has been the subject of research in severe migraine. Opioids are employed in pain, and its use in chronic headache is debatable, but these agents are employed in acute cases...
September 2015: Brazilian Journal of Anesthesiology
Priska Bastola, Hemant Bhagat, Jyotsna Wig
BACKGROUND AND AIMS: Both inhalational and intravenous anaesthetic agents are being used for neuroanaesthesia. Clinical trials comparing "propofol and sevoflurane" and "desflurane and sevoflurane" have been published. However, the comparison of all the three anaesthetics in neurosurgical patients has not been done. A randomised clinical study was carried out comparing propofol, sevoflurane and desflurane to find the ideal neuroanaesthetic agent. METHODS: A total of 75 adult patients undergoing elective craniotomy for supratentorial tumours were included in the study...
May 2015: Indian Journal of Anaesthesia
Reena Mahajan, Amit Kumar, Shiv Kumar Singh
Tetanus is an acute often fatal disease produced by gram positive obligate anaerobic bacterium Clostridium tetani. Tetanolysin damages local tissue and provides optimal conditions for bacterial multiplication. It is therefore important to perform a wide debridement of any wound suspected of being a portal of entry for the bacteria. Little evidence exists to recommend specific anesthetic protocols. We encountered a child scheduled for fracture both bone forearm with developing tetanus. Initial management done with intravenous (i...
January 2014: Anesthesia, Essays and Researches
Keiko M Tarquinio, Joy D Howell, Vicki Montgomery, David A Turner, Deyin D Hsing, Margaret M Parker, Calvin A Brown, Ron M Walls, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVES: Tracheal intubation in PICUs is often associated with adverse tracheal intubation-associated events. There is a paucity of data regarding medication selection for safe tracheal intubations in PICUs. Our primary objective was to evaluate the association of medication selection on specific tracheal intubation-associated events across PICUs. DESIGN: Prospective observational cohort study. SETTING: Nineteen PICUs in North America. SUBJECTS: Critically ill children requiring tracheal intubation...
March 2015: Pediatric Critical Care Medicine
Kadarapura N Gopalakrishna, Prasanta K Dash, Nilay Chatterjee, Hariharan V Easwer, Arimanickam Ganesamoorthi
BACKGROUND: Transnasal transsphenoidal (TNTS) resection of pituitary tumors involves wide fluctuation in hemodynamic parameter and causes hypertension and tachycardia due to intense noxious stimuli during various stages of surgery. None of routinely used anesthetic agents effectively blunts the undesirable hemodynamic responses, and therefore usually there is a need to use increased doses of anesthetic agents. Dexmedetomidine (DEX) an α-2 adrenergic receptor agonist, because its sympatholytic and antinociceptive properties may ensure optimal intraoperative hemodynamic stability during critical moments of surgical manipulation...
July 2015: Journal of Neurosurgical Anesthesiology
Parisa Partownavid, Bryan T Romito, Willy Ching, Ashley A Berry, Charles T Barkulis, KimNgan P Nguyen, Jonathan S Jahr
Although neuromuscular block (NMB) allows immobility for airway management and surgical exposure, termination of its effect is limited by and associated with side effects of acetylcholinesterase inhibitors. Sugammadex is a selective relaxant binding agent that has been shown to reverse deep NMB, even when administered 3 minutes following a 1.2 mg/kg dose of rocuronium. This novel drug is a modified gamma cyclodextrin, that through encapsulation process terminates the effects of rocuronium and vecuronium (aminosteroid muscle relaxants), and enables the anesthesiologists rapidly to reverse profound NMB induced by rocuronium or vecuronium, in a "can't ventilate, can't intubate" crisis...
July 2015: American Journal of Therapeutics
Geraldine Dapul, Pritesh Patel, Tejpaul Pannu, Jay Meythaler
OBJECTIVE: Severe tetanus remains a serious issue in less developed countries, leading to prolonged hospitalization due to prolonged neuromuscular contraction of muscles. We present a case of severe tetanus in the United States that was successfully managed with intrathecal baclofen. CASE REPORT: A 42-year-old male without tetanus vaccination history presented to the emergency department with intractable jaw pain and worsening diffuse muscle contractures due to severe generalized tetanus requiring prolonged paralysis and ventilator support...
December 2014: Neuromodulation: Journal of the International Neuromodulation Society
Mark Thomas, Vincenzo Salpietro, Natalie Canham, Martino Ruggieri, Rahul Phadke, Maria Kinali
Mitochondrial DNA depletion syndromes are an important cause of mitochondrial cytopathies in both children and adults. We describe a newborn with multiple congenital malformations including a right aberrant subclavian artery and a trachea-oesophageal fistula in whom mitochondrial depletion syndrome was unmasked by perioperative muscle relaxation. After vecuronium infusion, the infant developed an irreversible postoperative paralysis, leading to death 32 days after surgery. The present case highlights (a) the clinical heterogeneity of mitochondrial depletion syndrome; (b) the importance of rigorous antemortem and postmortem investigations when the cause of a severe myopathy is uncertain; (c) the possible coexistence of mitochondrial depletion syndrome and congenital malformations as a result of a likely abnormal antenatal embryofetal development and (d) the importance of a careful anaesthetic management of children with mitochondrial depletion syndrome, which could be prone to complications related to the possible depressive effects on mitochondrial electron transport chain mediated by some anaesthetic agents...
April 2015: Journal of Child Neurology
Mehmet A Elmacioglu, Sitki Goksu, Hasan Kocoglu, Unsal Oner
BACKGROUND: In surgical patients, decreasing the fresh gas flow rate in anesthesia may minimize costs, reduce environmental pollution, and preserve heat and humidity in the respiratory system. OBJECTIVE: The aim of this study was to investigate the effects of 3 low-flowdesflurane rates on perioperative hemodynamic stability, end-tidal desflurane concentration, emergence and recovery characteristics, and agent consumption. METHODS: This open-label, prospective study was conducted at the Departmentof Anesthesiology and Reanimation, University of Gaziantep, Gaziantep, Turkey...
January 2005: Current Therapeutic Research, Clinical and Experimental
Guoping Ma, Jingli Yang, Song Liu
Bronchial rupture occurred during bronchoscopic visualization and extraction of a fishbone from the bronchus in a 2-year-old male patient with a 5-month history of foreign body aspiration. Emergency thoracotomy was scheduled for examination and surgical repair of the bronchus. The pressure of the airway and circuit fell sharply and ventilation could not be maintained after muscle relaxants were injected and spontaneous respiration ceased. Oxygenation worsened rapidly with the peripheral oxygen saturation level decreasing below 60%...
May 2014: Paediatric Anaesthesia
Kathryn A Elofson, Sarah F Rhoads, Andrew Tang, Joshua B Gaither, Asad E Patanwala
INTRODUCTION: The purpose of this study was to determine the rate of long-acting neuromuscular blocker (LA-NMB) use and evaluate the concurrent use of sedatives during prehospital care. SETTING: Prehospital patients who were brought to a single emergency department in the United States. METHODS: This was a retrospective cohort study of trauma patients who were intubated in the prehospital setting. The primary outcome measure was to determine the rate of LA-NMB use...
July 2013: Air Medical Journal
Kiyoshi Nagase, Hiroki Iida
BACKGROUND: It is recommended to minimize neuromuscular blocker administration during general anesthesia for the efficacy of operating room utilization and potential hazards of unintended awareness during anesthesia. METHODS: We retrospectively compared the dose of vecuronium in consecutive 8,007 patients under general anesthesia receiving remifentanil or fentanyl. In analyzing electronic anesthesia records over 4 years in a single university institute, we also examined the type of general anesthesia and the required time of each pro- cedure in the operating room...
March 2012: Masui. the Japanese Journal of Anesthesiology
Osamu Tajiri, Hiroyuki Ito, Yasuko Yago, Yasushi Masumori
A 55-year-old woman underwent emergency cerebral aneurysm clipping for subarachnoid hemorrhage (SAH). Her past and family history was unremarkable. Preoperative blood examinations were within normal ranges except for a slight decrease in serum potassium level. ECG showed a prolonged QTc interval (0.54 sec). General anesthesia was induced with propofol, fentanyl and vecuronium, and maintained with 1-1.5% sevoflurane, 50% nitrous oxide in oxygen and intermitted doses of fentanyl. About three hours after starting the operation, bigeminal pulse appeared followed by torsade de pointes...
September 2011: Masui. the Japanese Journal of Anesthesiology
J Tang, G Wu, L Peng
OBJECTIVE: The aim of the study was to investigate the effects of acute hypervolemic hemodilution (HHD) on the pharmacokinetics of propofol in patients undergoing total hip replacement. METHODS: A total of 16 patients undergoing elective surgery for total hip replacement under general anesthesia in combination with epidural analgesia were randomly assigned to 2 groups: the control group (n = 8) or the HHD group (n = 8). All patients in both groups received lactated Ringer's solution before induction of general anesthesia...
September 2011: Der Anaesthesist
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