Journal ArticleDOI
Low-dose neostigmine to antagonise shallow atracurium neuromuscular block during inhalational anaesthesia: A randomised controlled trial.
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TLDR
Under desflurane anaesthesia, neostigmine 10 &mgr;g kg−1 is effective in antagonising shallow atracurium block and the time to a TOF ratio more than 0.9 was shortened and neuromuscular recovery at 5 and 10”min was more advanced.Abstract:
BACKGROUNDEven shallow residual neuromuscular block [i.e. train-of-four (TOF) ratio around 0.6] is harmful. It can be effectively antagonised by small doses of neostigmine, but reports are limited to intravenous anaesthesia. Inhalational anaesthesia may enhance neuromuscular block and delay recoveryread more
Citations
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Journal ArticleDOI
Current Status of Neuromuscular Reversal and Monitoring: Challenges and Opportunities.
Sorin J. Brull,Aaron F. Kopman +1 more
TL;DR: Objective measurement (a train-of-four ratio greater than 0.90) is the only method to determine appropriate timing of tracheal extubation and ensure normal muscle function and patient safety.
Journal ArticleDOI
Residual neuromuscular blockade: management and impact on postoperative pulmonary outcome.
TL;DR: There is convincing evidence in the literature that incomplete neuromuscular recovery may lead to a poor postoperative pulmonary outcome, and Sugammadex acts more rapidly and more predictably than neostigmine.
Journal ArticleDOI
Comparison of Clinical Trial Changes in Primary Outcome and Reported Intervention Effect Size Between Trial Registration and Publication.
Tao Chen,Tao Chen,Chao Li,Chao Li,Rui Qin,Yang Wang,Dahai Yu,James Dodd,Duolao Wang,Victoria Cornelius +9 more
TL;DR: In this cross-sectional study that included 389 trials, 130 of them had at least 1 primary outcome change between registration and publication, which significantly overestimated the reported intervention effect size.
Journal ArticleDOI
Qualitative Neuromuscular Monitoring: How to Optimize the Use of a Peripheral Nerve Stimulator to Reduce the Risk of Residual Neuromuscular Blockade
TL;DR: This review provides recommendations for anesthesia providers who may not yet have quantitative monitoring and sugammadex available and thus are providing care within the limitations of a conventional peripheral nerve stimulator (PNS) and neostigmine.
Journal ArticleDOI
Residual Paralysis: Does it Influence Outcome After Ambulatory Surgery?
TL;DR: The development and use of new selectively binding reversal agents (sugammadex and calabadion) warrants reevaluation of this area of clinical practice.
References
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Journal ArticleDOI
Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: the Stockholm revision.
Thomas Fuchs-Buder,C. Claudius,Lene Theil Skovgaard,L. I. Eriksson,Rajinder K. Mirakhur,Jørgen Viby-Mogensen +5 more
TL;DR: The set of guidelines for good clinical research practice (GCRP) in pharmacodynamic studies of neuromuscular blocking agents, which was developed following an international consensus conference in Copenhagen, has been revised and updated.
Journal ArticleDOI
Residual neuromuscular blockade and critical respiratory events in the postanesthesia care unit
Glenn S. Murphy,Joseph W. Szokol,Jesse H. Marymont,Steven Greenberg,Michael J. Avram,Jeffery S. Vender +5 more
TL;DR: It is suggested that incomplete neuromuscular recovery is an important contributing factor in the development of adverse respiratory events in the PACU, which was absent in control patients without CREs.
Journal ArticleDOI
Residual paralysis in the PACU after a single intubating dose of nondepolarizing muscle relaxant with an intermediate duration of action.
TL;DR: After a single dose of intermediate-duration muscle relaxant and no reversal, residual paralysis is common, even more than 2 h after the administration of muscle relaxants, as shown in patients enrolled in this study.
Journal ArticleDOI
Residual paralysis after emergence from anesthesia.
TL;DR: The data in the current literature on residual paralysis were obtained with acetylcholinesterase inhibitors as the only agents available to accelerate neuromuscular recovery, and assessment of practice in this regard is relevant now that sugammadex, a selective binding agent, has become available in certain parts of the world.
Journal ArticleDOI
The predisposition to inspiratory upper airway collapse during partial neuromuscular blockade.
Matthias Eikermann,Florian M. Vogt,Frank Herbstreit,Mehdi Vahid-Dastgerdi,Michael Zenge,Christof Ochterbeck,Armin de Greiff,Jürgen Peters +7 more
TL;DR: Assessment of supraglottic airway diameter and volume by respiratory-gated magnetic resonance imaging, upper airway dilator muscle function (genioglossus force and EMG), and changes in lung volume, respiratory timing, and peripheral muscle function before, during, and after partial neuromuscular blockade in healthy, awake volunteers concluded that impaired neuromUScular transmission markedly impairs upperAirway dimensions and function.