Journal Article•
Circulatory collapse following succinylcholine: report of a patient with diffuse lower motor neuron disease.
About: This article is published in Anesthesia & Analgesia.The article was published on 1971-05-01 and is currently open access. It has received 55 citations till now. The article focuses on the topics: Circulatory collapse.
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TL;DR: The normal development, maturation, and function of the NMJ are discussed, and Diseases of theNMJ are reviewed with emphasis on new etiologic, pathologic, and treatment-oriented information.
Abstract: THE mammalian neuromuscular junction (NMJ) is one of the most studied and best understood synapses. Recent work has brought forth new information as to development, maturation, and function of this fundamental synapse, both in health and disease. The healthy function of the NMJ underlies one important measurement of the response to general anesthetics, immobility. “Neuromuscular blockers” acting directly at the NMJ are used as a component of many balanced anesthetic techniques, and the health of the NMJ profoundly influences anesthetic technique. For these reasons, it is imperative that anesthesiologists be aware of new developments in the field. The normal development, maturation, and function of the NMJ are discussed. Diseases of the NMJ are also reviewed with emphasis on new etiologic, pathologic, and treatment-oriented information.
144 citations
Cites background from "Circulatory collapse following succ..."
...patients are at risk for hyperkalemia after administration of succinylcholine.(276) There may be a perceived hypersensitivity to nondepolarizing neuromuscular blockers...
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TL;DR: Perioperative medical care, anesthetic considerations, and the risk of postanesthetic respiratory failure in patients with pediatric spinal muscular atrophy (SMA) are described.
Abstract: Summary
Objective: To describe the perioperative medical care, anesthetic considerations, and the risk of postanesthetic respiratory failure in patients with pediatric spinal muscular atrophy (SMA)
Methods: There is a retrospective chart review carried out at an urban, tertiary care pediatric hospital All patients with ICD-9 codes corresponding to SMA diagnoses were identified, and records screened for anesthetic and perioperative medical management Medical records were reviewed for demographic, clinical, and outcome data
Main results: Twenty-five children with SMA (10 type I, 8 type II, 7 type III) accounted for 56 general and regional anesthetic cases Twenty-one (38%) cases had preexisting ventilator dependence Total intravenous anesthesia with nitrous oxide was provided in 14 (25%) cases, balanced anesthesia with inhalational agents and epidural or systemic opioids were used in 41 (84%) cases, and one infant received a spinal anesthesia Intraoperative and postoperative complications occurred in 2 (4%) and 2 (4%) cases respectively One case required an unplanned postanesthetic intensive care unit admission, and there were two late deaths with redirection of care
Conclusions: Perioperative care can be provided for children with SMA safely and effectively with total intravenous or inhaled anesthetics along with the judicious use of opioids to improve patient comfort without increased morbidity Further prospective studies of standardized anesthetic and perioperative respiratory medical management in this population are required to minimize the decompensation of tenuous preoperative respiratory function
98 citations
TL;DR: The normal hyperkalaemic response to suxamethonium, the factors affecting it, the conditions in which it may be exaggerated, and the periods of high risk are described.
Abstract: Severe life-threatening hyperkalaemia may occur following administration of suxamethonium during certain periods after burns, neurological injuries, and in certain other conditions. Although this response is well-known, there is disagreement about when it may occur. This review describes the normal hyperkalaemic response to suxamethonium, the factors affecting it, the conditions in which it may be exaggerated, and the periods of high risk.
76 citations
TL;DR: When patients requiring tracheal intubation present with potential contraindications to succinylcholine use, the emergency physician will need to substitute a rapid-onset nondepolarizing neuromuscular blocking agent, such as rocuronium or mivacurium.
Abstract: Succinylcholine has long been the favored neuromuscular blocking agent for emergent airway management because of its rapid onset, dependable effect, and short duration. However, it has a plethora of undesirable side effects, ranging from the inconsequential to the catastrophic. When patients requiring tracheal intubation present with potential contraindications to succinylcholine use, the emergency physician will need to substitute a rapid-onset nondepolarizing neuromuscular blocking agent, such as rocuronium or mivacurium. An understanding of the pharmacology of these agents is essential.
69 citations
TL;DR: Treatment with plasma exchange and immune globulins has decreased the duration of mechanical ventilation by half, but patients still require mechanical ventilation and 5% to 10% remain seriously disabled, and 3% to 8% die as a result of largely avoidable complications.
58 citations