keyword
https://read.qxmd.com/read/38460887/relationship-between-muscle-mass-ratio-and-rocuronium-dose-required-for-maintaining-deep-neuromuscular-blockade-a-prospective-observational-study
#1
JOURNAL ARTICLE
Jiwon Han, Ah-Young Oh, Jung-Won Hwang, Sun Woo Nam
BACKGROUND: Deep neuromuscular blockade (NMB) has benefits in various surgical procedures, however, precise quantitative neuromuscular monitoring is crucial for its proper maintenance and recovery. Neuromuscular blocking agent dosage relies on actual body weight (ABW), but this varies among individuals. Therefore, this study hypothesizes that there is a correlation between the rocuronium requirement for deep NMB and muscle mass ratio measured by bioelectric impedance analysis. METHODS: Ninety adult female patients undergoing laparoscopic operation were enrolled in this study...
March 7, 2024: Anaesthesia, Critical Care & Pain Medicine
https://read.qxmd.com/read/37795279/allergic-reactions-to-sugammadex-a-case-series-and-review-of-the-literature
#2
JOURNAL ARTICLE
Rita Banoub, Emmanuel Alalade, Jason Bryant, Peter Winch, And Joseph D Tobias
Sugammadex is a novel agent for the reversal of neuromuscular blockade; it acts by encapsulating -rocuronium or vecuronium, eliminating the active compound from the circulation, thereby providing rapid and complete recovery even with profound or complete neuromuscular blockade. Clinical advantages, including reduced incidence of residual blockade, decreased nausea and vomiting, decreased dry mouth, less change in heart rate, and reduced pulmonary complications, have been demonstrated when comparing sugammadex to conventional agents, such as neostigmine, that inhibit acetylcholinesterase...
2023: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://read.qxmd.com/read/37505153/comparison-of-remimazolam-and-propofol-induction-on-hemodynamic-response-in-hypertensive-patients
#3
RANDOMIZED CONTROLLED TRIAL
Eun Kyung Choi, Youngjun Jang, Sang-Jin Park
BACKGROUND: Hemodynamic variations during the induction of general anesthesia are more profound in hypertensive patients, and the risk of hypoperfusion-induced organ damage followed by hypotensive episodes is higher in hypertensive patients than in normotensive patients. Thus, we compared the effects of remimazolam and propofol on hemodynamics during general anesthesia induction in hypertensive patients. METHODS: Patients were randomly divided into the remimazolam (Group R, n = 48) and propofol (Group P, n = 48) groups: remimazolam was continued at 6 mg/kg/hour until the patient lost consciousness, followed by 1 mg/kg/hour until 5 minutes after tracheal intubation...
July 28, 2023: Medicine (Baltimore)
https://read.qxmd.com/read/36621572/perioperative-neuromuscular-blockade-2020-update-of-the-sedar-sociedad-espa%C3%A3-ola-de-anestesiolog%C3%A3-a-y-reanimaci%C3%A3-n-recommendations
#4
O Díaz-Cambronero, A Serrano, A Abad-Gurumeta, I Garutti Martinez, N Esteve, E Alday, C Ferrando, G Mazzinari, P Vila-Caral, C L Errando Oyonarte
We present an update of the 2020 Recommendations on neuromuscular blockade of the SEDAR. The previous ones dated 2009. A modified Delphi consensus analysis (experts, working group, and previous extensive bibliographic revision) 10 recommendations were produced1 : neuromuscular blocking agents were recommended for endotracheal intubation and to avoid faringo-laryngeal and tracheal lesions, including critical care patients.2 We recommend not to use neuromuscular blocking agents for routine insertion of supraglotic airway devices, and to use it only in cases of airway obstruction or endotracheal intubation through the device...
January 2023: Revista española de anestesiología y reanimación
https://read.qxmd.com/read/35378568/adverse-events-of-sugammadex-that-occurred-in-a-korean-population
#5
JOURNAL ARTICLE
Woong Han, Jong Min Lee, Dong Ho Park, Chia An Lee, Chang Yeong Jeong, Hong Seuk Yang
BACKGROUND: With increasing use, the incidence of adverse events associated with sugammadex, a neuromuscular blockade reverser, is increasing. This study aimed to identify and analyze cases of adverse events caused by sugammadex reported in Korean population. METHODS: Out of a total of 12 cases detected using various keywords in the Korean Journal of Anesthesia, Anesthesia and Pain Medicine (Seoul), KoreaMed, PubMed, EMBASE, Web of Science, and The Cochrane Library-CENTRAL from 2013 to December 2020, 10 cases directly associated with sugammadex were selected...
April 2022: Anesthesia and pain medicine
https://read.qxmd.com/read/35120713/comparison-of-two-pharmacokinetic-pharmacodynamic-models-of-rocuronium-bromide-during-profound-neuromuscular-block-analysis-of-estimated-and-measured-post-tetanic-count-effect
#6
JOURNAL ARTICLE
Mafalda Couto, Sérgio Vide, Nicolás Marco-Ariño, Iñaki F Troconiz, Simão Esteves, Catarina S Nunes, Pedro Amorim, Joaquim Mendes
BACKGROUND: Profound neuromuscular block (NMB) is important in surgeries where complete immobility is considered essential to improve tracheal intubation and surgical conditions. Rocuronium bromide is a commonly used NMB agent. This work describes a noninvasive approach for estimation of post-tetanic count (PTC) based on two pharmacokinetic (PK) models, the Saldien and the De Haes models. The aim was to investigate the rocuronium bromide PK-pharmacodynamic (PD) relationship in estimating the PTC effect during profound NMB...
March 2022: British Journal of Anaesthesia
https://read.qxmd.com/read/34889149/unanticipated-profound-paralysis-and-sugammadex-dosing-implications-after-videoscopic-thoracic-surgery
#7
JOURNAL ARTICLE
Melissa L McKittrick, Frederick W Lombard
A bedridden patient with empyema presented for thoracoscopic decortication. During the procedure, despite a post-tetanic count (PTC) of 0 via calibrated quantitative neuromuscular monitoring, persistent diaphragmatic movement impaired operating conditions, so rocuronium was re-dosed. After surgery, the patient had 0 PTC. Sugammadex was titrated to achieve baseline neuromuscular strength, monitoring the effect of each 200-mg dose. Ultimately, 1200 mg was required to achieve baseline strength. We describe monitor troubleshooting, considerations with unexpectedly deep neuromuscular blockade, the importance of routine quantitative neuromuscular monitoring, and one strategy for sugammadex reversal in patients with profound paralysis outside of the standard dosing guidelines...
March 2022: Seminars in Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/34249560/clinical-impact-of-sugammadex-in-the-reversal-of-neuromuscular-blockade
#8
JOURNAL ARTICLE
Joshua A Goodner, Eric J Likar, Abigail L Hoff, Jeffrey M Quedado, Arpan Kohli, Pavithra Ellison
Background A neuromuscular blockade (NMB) is used in general anesthesia to facilitate endotracheal intubation and muscle relaxation during procedural and surgical interventions. Rapid and complete reversal of the NMB allows for patient recovery to the preoperative baseline with ventilation and motor function, along with the complete return of gastroesophageal motility, thereby expediting recovery and preventing microaspiration in the postoperative period. Sugammadex is a modified gamma cyclodextrin that complexes with steroidal neuromuscular blocking agents (specifically, rocuronium and vecuronium), leading to a molecular gradient and removal of the agents from the neuromuscular junction...
June 2021: Curēus
https://read.qxmd.com/read/34056122/automated-quantitative-relaxometry-for-deep-neuromuscular-blockade-in-robot-assisted-prostatectomy
#9
JOURNAL ARTICLE
Michèle Sunnen, Martin Schläpfer, Peter Biro
PURPOSE: During pneumoperitoneum (PP) for robot-assisted prostatectomy, a deep neuromuscular block (NMB) is necessary. New relaxometry equipment permits maintenance of profound NMB in order to improve patient safety and surgical conditions. METHODS: Twenty adult patients undergoing robot-assisted prostatectomy were included. Under automated quantitative relaxometry with the TOFcuffTM device, rocuronium dosing was adapted with the aim to keep NMB at deep levels. The time fractions with intense block (PTC 0), adequately deep block (PTC 1 to 3) and a not sufficiently deep block (PTC > 3) were quantified...
July 2020: Romanian Journal of Anaesthesia and Intensive Care
https://read.qxmd.com/read/33593283/economic-impact-of-improving-patient-safety-using-sugammadex-for-routine-reversal-of-neuromuscular-blockade-in-spain
#10
JOURNAL ARTICLE
J Martinez-Ubieto, C Aragón-Benedí, J de Pedro, L Cea-Calvo, A Morell, Y Jiang, S Cedillo, P Ramírez-Boix, A M Pascual-Bellosta
BACKGROUND: Neuromuscular blocking (NMB) agents are often administered to facilitate tracheal intubation and prevent patient movement during surgical procedures requiring the use of general anesthetics. Incomplete reversal of NMB, can lead to residual NMB, which can increase the risk of post-operative pulmonary complications. Sugammadex is indicated to reverse neuromuscular blockade induced by rocuronium or vecuronium in adults. The aim of this study is to estimate the clinical and economic impact of introducing sugammadex to routine reversal of neuromuscular blockade (NMB) with rocuronium in Spain...
February 16, 2021: BMC Anesthesiology
https://read.qxmd.com/read/33424509/emergency-sugammadex-reversal-in-an-850-g-premature-infant-a-case-report
#11
Proshad N Efune, Gijo Alex, Sonia D Mehta
Sugammadex is a novel reversal agent for the neuromuscular blocking agents rocuronium and vecuronium; it has been shown to rapidly and completely reverse neuromuscular blockade for rocuronium and vecuronium, even when the blockade is profound. We present the case of a 2-week-old, 850-g infant born at 25 weeks' gestation, who presented to the operating room for exploratory laparotomy and repair of ileal atresia. Anesthesia was induced and neuromuscular blockade with 1.2 mg/kg of rocuronium was administered. The neonate experienced rapid oxyhemoglobin desaturation and progressively became very difficult to mask ventilate...
2021: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://read.qxmd.com/read/32891179/dramatic-neurological-and-biological-effects-by-botulinum-neurotoxin-type-a-on-sh-sy5y-neuroblastoma-cells-beyond-the-blockade-of-neurotransmitter-release
#12
JOURNAL ARTICLE
Lei Wang, Carol S Ringelberg, Bal R Singh
BACKGROUND: Gene expression profile analysis on mammalian cell lines and animal models after exposure to botulinum neurotoxin (BoNT) has been investigated in several studies in recent years. Microarray analysis provides a powerful tool for identifying critical signaling pathways involved in the biological and inflammatory responses to BoNT and helps determine the mechanism of the function of botulinum toxins. One of the pivotal clinical characteristics of BoNT is its prolonged on-site effects...
September 5, 2020: BMC Pharmacology & Toxicology
https://read.qxmd.com/read/32766960/history-of-the-development-of-antagonists-for-neuromuscular-blocking-agents
#13
JOURNAL ARTICLE
Keiko Suzuki, Tomonori Takazawa, Shigeru Saito
Muscle relaxation induced by neuromuscular blocking agents (NMBAs) is necessary for tracheal intubation and immobilization during surgery. Although acetylcholinesterase inhibitors have been successfully used as antagonists for NMBAs, they have their limitations; their effects are transient and ineffective against profound neuromuscular blockade. In the past, alternative antagonists were developed, such as germine and 4-aminopyridine, which are effective for the treatment of diseases causing muscle weakness and could potentially be used as antagonists for NMBAs...
October 2020: Journal of Anesthesia
https://read.qxmd.com/read/32656687/individual-pharmacometric-analysis-for-sugammadex-reversal-and-re-administration-of-neuromuscular-blockade
#14
JOURNAL ARTICLE
Yuki Kashima, Kenichi Masui
Sugammadex is an innovative reversal agent for neuromuscular blockade (NMB) induced by rocuronium. Although there is a case that re-paralysis is necessary after sugammadex administration, limited reports can be found on the sugammadex dosage for reversal from profound paralysis after induction and immediate re-paralysis following such reversal in detail. We experienced a case in which NMB reversal was required in a short period after paralysis for induction due to the discovery of anisocoria. We successfully re-induced general anesthesia with tracheal intubation soon after...
October 2020: Journal of Anesthesia
https://read.qxmd.com/read/31725475/rocuronium-continuous-infusion-for-profound-neuromuscular-blockade-a-systematic-review-and-meta-analysis
#15
JOURNAL ARTICLE
Mafalda Couto, Catarina Nunes, Sérgio Vide, Pedro Amorim, Joaquim Mendes
OBJECTIVES: Rocuronium is a muscle relaxant with increased use, because of the binding relation with the reversal agent sugammadex. Its continuous infusion benefits the maintenance of deeper levels of neuromuscular blockade (NMB) ensuring an improved and stable solution for daily surgical anesthesia. This is systematic review on current approaches on rocuronium infusion and monitoring parameters when using rocuronium continuous infusion for profound muscle relaxation (0-2 posttetanic count)...
November 2019: Clinical Neuropharmacology
https://read.qxmd.com/read/31678425/safety-tolerability-and-pharmacokinetics-of-adamgammadex-sodium-a-novel-agent-to-reverse-the-action-of-rocuronium-and-vecuronium-in-healthy-volunteers
#16
RANDOMIZED CONTROLLED TRIAL
YingYing Jiang, YuJun Zhang, ShunJu Xiang, WenLing Zhao, Jin Liu, WenSheng Zhang
Neuromuscular blockers (NMBs) selectively block neuromuscular transmission at the N2-nicotinic receptor on motor neurons to paralyze skeletal muscles, and are mainly used to facilitate tracheal intubation and surgical procedures. Rapid reversal is necessary in clinical practice to avoid profound block and reduce recovery time. Adamgammadex sodium is a modified γ-cyclodextrin derivative consisting of a lipophilic core and a hydrophilic outer end that forms an inactive tight inclusion complex with free molecules of rocuronium and vecuronium...
January 1, 2020: European Journal of Pharmaceutical Sciences
https://read.qxmd.com/read/30920983/efficacy-of-profound-versus-moderate-neuromuscular-blockade-in-enhancing-postoperative-recovery-after-laparoscopic-donor-nephrectomy-a-randomised-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Moira H D Bruintjes, Piet Krijtenburg, Chris H Martini, Paul P Poyck, Frank C H d'Ancona, Volkert A L Huurman, Michel van der Jagt, Johan F Langenhuijsen, Willemijn N Nijboer, Cornelis J H M van Laarhoven, Albert Dahan, Michiel C Warlé
BACKGROUND: Profound neuromuscular blockade (NMB) during anaesthesia has been shown to reduce postoperative pain scores, when compared with a moderate block. We hypothesised that profound NMB during laparoscopic donor nephrectomy (LDN) could also improve the early quality of recovery after surgery. OBJECTIVES: To compare the effectiveness of profound versus moderate NMB during LDN in enhancing postoperative recovery. DESIGN: A phase IV, double-blinded, randomised controlled trial...
July 2019: European Journal of Anaesthesiology
https://read.qxmd.com/read/30573962/reevaluation-and-update-on-efficacy-and-safety-of-neostigmine-for-reversal-of-neuromuscular-blockade
#18
REVIEW
Jie Luo, Shuting Chen, Su Min, Lihua Peng
Postoperative residual neuromuscular block is a serious threat which endangers the patient safety. Neostigmine has been the most commonly used anticholinesterase for the pharmacological reversal of neuromuscular blockade. Although newer agents have been introduced recently, neostigmine has some irreplaceable advantages, including broad-spectrum reversal of all nondepolarizing neuromuscular blocking drugs, low cost, and availability of more related data for clinical practice to refer to. Neostigmine is also noticed to have some drawbacks, such as the inability to reverse profound and deep blockade, potential induction of muscle weakness, cardiovascular adverse effects, and so on...
2018: Therapeutics and Clinical Risk Management
https://read.qxmd.com/read/30004912/profound-bradycardia-and-cardiac-arrest-after-sugammadex-administration-in-a-previously-healthy-patient-a-case-report
#19
JOURNAL ARTICLE
Ivanna A Sanoja, Kenneth S Toth
We report the case of a 60-year-old man who underwent open radical prostatectomy for prostate adenocarcinoma. He had no known cardiac disease or symptoms other than controlled hypertension and remote history of cocaine use. The patient was given sugammadex for reversal of neuromuscular blockade and, within 1 minute, developed severe, drug-resistant bradycardia followed by pulseless electrical activity arrest. Advanced cardiac life support was initiated and continued for 15 minutes before the return of spontaneous circulation...
January 1, 2019: A&A Practice
https://read.qxmd.com/read/29178460/the-adequate-rocuronium-dose-required-for-complete-block-of-the-adductor-muscles-of-the-thigh
#20
JOURNAL ARTICLE
M Fujimoto, K Kawano, T Yamamoto
BACKGROUND: Rocuronium can prevent the obturator jerk during transurethral resection of bladder tumors. We investigated the adequate rocuronium dose required for complete block of the thigh adductor muscles, and its correlation with individual responses of the adductor pollicis muscle to rocuronium. METHODS: Eleven patients scheduled for transurethral resection of bladder tumors under general anesthesia were investigated. After general anesthesia induction, neuromuscular monitoring of the adductor pollicis muscle and ultrasonography-guided stimulation of the obturator nerve was commenced...
March 2018: Acta Anaesthesiologica Scandinavica
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