The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. It is distinguished from NERVE BLOCK in which nerve conduction (NEURAL CONDUCTION) is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here.
Drugs that interrupt transmission of nerve impulses at the skeletal neuromuscular junction. They can be of two types, competitive, stabilizing blockers (NEUROMUSCULAR NONDEPOLARIZING AGENTS) or noncompetitive, depolarizing agents (NEUROMUSCULAR DEPOLARIZING AGENTS). Both prevent acetylcholine from triggering the muscle contraction and they are used as anesthesia adjuvants, as relaxants during electroshock, in convulsive states, etc.
Cyclic GLUCANS consisting of eight (8) glucopyranose units linked by 1,4-glycosidic bonds.
Monoquaternary homolog of PANCURONIUM. A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.
A bis-quaternary steroid that is a competitive nicotinic antagonist. As a neuromuscular blocking agent it is more potent than CURARE but has less effect on the circulatory system and on histamine release.
Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. They prevent acetylcholine from triggering muscle contraction and are used as muscle relaxants during electroshock treatments, in convulsive states, and as anesthesia adjuvants.
Androstanes and androstane derivatives which are substituted in any position with one or more hydroxyl groups.
A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike PHYSOSTIGMINE, does not cross the blood-brain barrier.
A rapid-onset, short-acting cholinesterase inhibitor used in cardiac arrhythmias and in the diagnosis of myasthenia gravis. It has also been used as an antidote to curare principles.
A non-depolarizing neuromuscular blocking agent with short duration of action. Its lack of significant cardiovascular effects and its lack of dependence on good kidney function for elimination provide clinical advantage over alternate non-depolarizing neuromuscular blocking agents.
The synapse between a neuron and a muscle.
A neuromuscular blocker and active ingredient in CURARE; plant based alkaloid of Menispermaceae.
A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.
A major nerve of the upper extremity. In humans, the fibers of the ulnar nerve originate in the lower cervical and upper thoracic spinal cord (usually C7 to T1), travel via the medial cord of the brachial plexus, and supply sensory and motor innervation to parts of the hand and forearm.
Compounds that contain the decamethylenebis(trimethyl)ammonium radical. These compounds frequently act as neuromuscular depolarizing agents.
A piperazinyl androstane derivative which is a non-depolarizing neuromuscular blocking agent (NEUROMUSCULAR NONDEPOLARIZING AGENTS). It is used as a muscle relaxant during ANESTHESIA and surgical procedures.
The period of emergence from general anesthesia, where different elements of consciousness return at different rates.
Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.
Abnormally slow pace of regaining CONSCIOUSNESS after general anesthesia (ANESTHESIA, GENERAL) usually given during surgical procedures. This condition is characterized by persistent somnolence.
Drugs that interrupt transmission at the skeletal neuromuscular junction by causing sustained depolarization of the motor end plate. These agents are primarily used as adjuvants in surgical anesthesia to cause skeletal muscle relaxation.
Plant extracts from several species, including genera STRYCHNOS and Chondodendron, which contain TETRAHYDROISOQUINOLINES that produce PARALYSIS of skeletal muscle. These extracts are toxic and must be used with the administration of artificial respiration.
A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45)
Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract.
A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
The first digit on the radial side of the hand which in humans lies opposite the other four.
The recording of muscular movements. The apparatus is called a myograph, the record or tracing, a myogram. (From Stedman, 25th ed)
Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.
An extremely stable inhalation anesthetic that allows rapid adjustments of anesthesia depth with little change in pulse or respiratory rate.
The striated muscle groups which move the LARYNX as a whole or its parts, such as altering tension of the VOCAL CORDS, or size of the slit (RIMA GLOTTIDIS).
The constant checking on the state or condition of a patient during the course of a surgical operation (e.g., checking of vital signs).
A group of compounds with the heterocyclic ring structure of benzo(c)pyridine. The ring structure is characteristic of the group of opium alkaloids such as papaverine. (From Stedman, 25th ed)
Biological actions and events that constitute the functions of the NERVOUS SYSTEM.
SESQUITERPENES cyclized into two adjoining cyclohexane rings but with a different configuration from the ARTEMISININS.
Drugs that inhibit cholinesterases. The neurotransmitter ACETYLCHOLINE is rapidly hydrolyzed, and thereby inactivated, by cholinesterases. When cholinesterases are inhibited, the action of endogenously released acetylcholine at cholinergic synapses is potentiated. Cholinesterase inhibitors are widely used clinically for their potentiation of cholinergic inputs to the gastrointestinal tract and urinary bladder, the eye, and skeletal muscles; they are also used for their effects on the heart and the central nervous system.
The musculofibrous partition that separates the THORACIC CAVITY from the ABDOMINAL CAVITY. Contraction of the diaphragm increases the volume of the thoracic cavity aiding INHALATION.
The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm.
A cholinesterase inhibitor with a slightly longer duration of action than NEOSTIGMINE. It is used in the treatment of myasthenia gravis and to reverse the actions of muscle relaxants.
Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.
A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.
The use of peripheral nerve stimulation to assess transmission at the NEUROMUSCULAR JUNCTION, especially in the response to anesthetics, such as the intensity of NEUROMUSCULAR BLOCKADE by NEUROMUSCULAR BLOCKING AGENTS.
A nonflammable, halogenated, hydrocarbon anesthetic that provides relatively rapid induction with little or no excitement. Analgesia may not be adequate. NITROUS OXIDE is often given concomitantly. Because halothane may not produce sufficient muscle relaxation, supplemental neuromuscular blocking agents may be required. (From AMA Drug Evaluations Annual, 1994, p178)
A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)
A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments.
The relationship between the dose of an administered drug and the response of the organism to the drug.
A synthetic nondepolarizing blocking drug. The actions of gallamine triethiodide are similar to those of TUBOCURARINE, but this agent blocks the cardiac vagus and may cause sinus tachycardia and, occasionally, hypertension and increased cardiac output. It should be used cautiously in patients at risk from increased heart rate but may be preferred for patients with bradycardia. (From AMA Drug Evaluations Annual, 1992, p198)
The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and SALIVARY GLANDS, and convey afferent information for TASTE from the anterior two-thirds of the TONGUE and for TOUCH from the EXTERNAL EAR.
Process of administering an anesthetic through injection directly into the bloodstream.
A state due to excess loss of carbon dioxide from the body. (Dorland, 27th ed)
Use of electric potential or currents to elicit biological responses.
Elements of limited time intervals, contributing to particular results or situations.
Recording of the changes in electric potential of muscle by means of surface or needle electrodes.
A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
A barbiturate that is administered intravenously for the induction of general anesthesia or for the production of complete anesthesia of short duration.
Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.
A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)
Neurotoxic proteins from the venom of the banded or Formosan krait (Bungarus multicinctus, an elapid snake). alpha-Bungarotoxin blocks nicotinic acetylcholine receptors and has been used to isolate and study them; beta- and gamma-bungarotoxins act presynaptically causing acetylcholine release and depletion. Both alpha and beta forms have been characterized, the alpha being similar to the large, long or Type II neurotoxins from other elapid venoms.
A group of compounds that contain the general formula R-OCH3.
The number of times the HEART VENTRICLES contract per unit of time, usually per minute.
The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine.
Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2).
An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.
A type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anesthesia in certain patients. It is introduced into the hypopharynx to form a seal around the larynx thus permitting spontaneous or positive pressure ventilation without penetration of the larynx or esophagus. It is used in place of a facemask in routine anesthesia. The advantages over standard mask anesthesia are better airway control, minimal anesthetic gas leakage, a secure airway during patient transport to the recovery area, and minimal postoperative problems.
The communication from a NEURON to a target (neuron, muscle, or secretory cell) across a SYNAPSE. In chemical synaptic transmission, the presynaptic neuron releases a NEUROTRANSMITTER that diffuses across the synaptic cleft and binds to specific synaptic receptors, activating them. The activated receptors modulate specific ion channels and/or second-messenger systems in the postsynaptic cell. In electrical synaptic transmission, electrical signals are communicated as an ionic current flow across ELECTRICAL SYNAPSES.
The action of a drug that may affect the activity, metabolism, or toxicity of another drug.
Contractile tissue that produces movement in animals.
The domestic cat, Felis catus, of the carnivore family FELIDAE, comprising over 30 different breeds. The domestic cat is descended primarily from the wild cat of Africa and extreme southwestern Asia. Though probably present in towns in Palestine as long ago as 7000 years, actual domestication occurred in Egypt about 4000 years ago. (From Walker's Mammals of the World, 6th ed, p801)
Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.
Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)
These include the muscles of the DIAPHRAGM and the INTERCOSTAL MUSCLES.
The determination of oxygen-hemoglobin saturation of blood either by withdrawing a sample and passing it through a classical photoelectric oximeter or by electrodes attached to some translucent part of the body like finger, earlobe, or skin fold. It includes non-invasive oxygen monitoring by pulse oximetry.
Abnormally low BODY TEMPERATURE that is intentionally induced in warm-blooded animals by artificial means. In humans, mild or moderate hypothermia has been used to reduce tissue damages, particularly after cardiac or spinal cord injuries and during subsequent surgeries.
A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.
Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility.
Gases or volatile liquids that vary in the rate at which they induce anesthesia; potency; the degree of circulation, respiratory, or neuromuscular depression they produce; and analgesic effects. Inhalation anesthetics have advantages over intravenous agents in that the depth of anesthesia can be changed rapidly by altering the inhaled concentration. Because of their rapid elimination, any postoperative respiratory depression is of relatively short duration. (From AMA Drug Evaluations Annual, 1994, p173)
The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= OXYGEN CONSUMPTION) or cell respiration (= CELL RESPIRATION).
That phase of a muscle twitch during which a muscle returns to a resting position.
The physical or mechanical action of the LUNGS; DIAPHRAGM; RIBS; and CHEST WALL during respiration. It includes airflow, lung volume, neural and reflex controls, mechanoreceptors, breathing patterns, etc.
Cell surface proteins that bind acetylcholine with high affinity and trigger intracellular changes influencing the behavior of cells. Cholinergic receptors are divided into two major classes, muscarinic and nicotinic, based originally on their affinity for nicotine and muscarine. Each group is further subdivided based on pharmacology, location, mode of action, and/or molecular biology.
The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.
Injections made into a vein for therapeutic or experimental purposes.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.

Are changes in the evoked electromyogram during anaesthesia without neuromuscular blocking agents caused by failure of supramaximal nerve stimulation? (1/235)

The evoked electromyogram often decreases during anaesthesia in the absence of neuromuscular block. We have measured the electromyogram of the first dorsal interosseous muscle evoked by train-of-four stimulation of the ulnar nerve in 63 patients undergoing anaesthesia for minor surgery. We used Medicotest P-00-S electrodes, a Datex Relaxograph and a current sink in the stimulating leads in parallel with the current path through the patient. The current sink was used to shunt some of the maximum available output current from the Relaxograph while maintaining the supramaximal stimulus current passing through the patient. After 30 min of anaesthesia, when the muscle response to train-of-four was stable, the ulnar nerve stimulus current was increased by reducing the proportion shunted through the current sink. The electromyographic response did not change during the study in 13 patients. In the remaining 50 patients, the response decreased to 78.4% (SD 27.1%, range 7.5-95.0%) of baseline values over the first 20 min of anaesthesia. In 22 of these patients, the electromyographic response increased from 71.4 (SD 22.6)% to 92.3 (9.5)% of baseline responses when the stimulus current was increased by 12.3 (2.4) mA, while in the remaining 28 patients the response decreased to 83.7 (10.6)% and did not increase with increasing stimulus current. These results suggest that loss of supramaximal stimulation is partly responsible for the observed changes in the evoked electromyogram during anaesthesia.  (+info)

Antagonism of vecuronium-induced neuromuscular block in patients pretreated with magnesium sulphate: dose-effect relationship of neostigmine. (2/235)

We have investigated the dose-effect relationship of neostigmine in antagonizing vecuronium-induced neuromuscular block with and without magnesium sulphate (MgSO4) pretreatment. Neuromuscular block was assessed by electromyography with train-of-four (TOF) stimulation. First, we determined neostigmine-induced recovery in patients pretreated with MgSO4 (group A) or saline (group B) (n = 12 each). The height of T1, 5 min after neostigmine, was 43 (7)% in group A and 65 (6)% in group B (P < 0.01). Respective values after 10 min were 59 (7)% and 83 (5)% (P < 0.01). TOF ratio, 5 min after neostigmine, was 29 (6)% in group A and 29 (5)% in group B. Respective values after 10 min were 38 (11)% and 51 (7)% (P < 0.01). To gain insight into the mechanisms leading to delayed recovery after MgSO4, we calculated assisted recovery, defined as neostigmine-induced recovery minus mean spontaneous recovery. Spontaneous recovery was assessed in another 24 patients. Patients in group C received MgSO4/vecuronium and patients in group D vecuronium only (n = 12 each). Five minutes after neostigmine, assisted recovery was 22 (7)% in the MgSO4 pretreated patients and 28 (6)% in controls (P < 0.05). Ten minutes after neostigmine, values were 24 (7)% and 22 (6)%. Maximum assisted recovery was not influenced by MgSO4 pretreatment (27 (6)% in group A and 32 (6)% in group B) and time to maximum effect was comparable between groups: 6 (4-10) min and 7 (5-8) min, respectively. We conclude that neostigmine-induced recovery was attenuated in patients treated with MgSO4. This was mainly a result of slower spontaneous recovery and not decreased response to neostigmine.  (+info)

SI neuron response variability is stimulus tuned and NMDA receptor dependent. (3/235)

Skin brushing stimuli were used to evoke spike discharge activity in single skin mechanoreceptive afferents (sMRAs) and anterior parietal cortical (SI) neurons of anesthetized monkeys (Macaca fascicularis). In the initial experiments 10-50 presentations of each of 8 different stimulus velocities were delivered to the linear skin path from which maximal spike discharge activity could be evoked. Mean rate of spike firing evoked by each velocity (MFR) was computed for the time period during which spike discharge activity exceeded background, and an across-presentations estimate of mean firing rate (MFR) was generated for each velocity. The magnitude of the trial-by-trial variation in the response (estimated as CV; where CV = standard deviation in MFR/MFR) was determined for each unit at each velocity. MFR for both sMRAs and SI neurons (MFRsMRA and MFRSI, respectively) increased monotonically with velocity over the range 1-100 cm/s. At all velocities the average estimate of intertrial response variation for SI neurons (CVSI) was substantially larger than the corresponding average for sMRAs (CVsMRA). Whereas CVsMRA increased monotonically over the range 1-100 cm/s, CVSI decreased progressively with velocity over the range 1-10 cm/s, and then increased with velocity over the range 10-100 cm/s. The position of the skin brushing stimulus in the receptive field (RF) was varied in the second series of experiments. It was found that the magnitude of CVSI varied systematically with stimulus position in the RF: that is, CVSI was lowest for a particular velocity and direction of stimulus motion when the skin brushing stimulus traversed the RF center, and CVSI increased progressively as the distance between the stimulus path and the RF center increased. In the third series of experiments, either phencylidine (PCP; 100-500 microg/kg) or ketamine (KET; 0.5-7.5 mg/kg) was administered intravenously (iv) to assess the effect of block of N-methyl-D-aspartate (NMDA) receptors on SI neuron intertrial response variation. The effects of PCP on both CVSI and MFRSI were transient, typically with full recovery occurring in 1-2 h after drug injection. The effects of KET on CVSI and MFRSI were similar to those of PCP, but were shorter in duration (15-30 min). PCP and KET administration consistently was accompanied by a reduction of CVSI. The magnitude of the reduction of CVSI by PCP or KET was associated with the magnitude of CVSI before drug administration: that is, the larger the predrug CVSI, the larger the reduction in CVSI caused by PCP or KET. PCP and KET exerted variable effects on SI neuron mean firing rate that could differ greatly from one neuron to the next. The results are interpreted to indicate that SI neuron intertrial response variation is 1) stimulus tuned (intertrial response variation is lowest when the skin stimulus moves at 10 cm/s and traverses the neuron's RF center) and 2) NMDA receptor dependent (intertrial response variation is least when NMDA receptor activity contributes minimally to the response, and increases as the contribution of NMDA receptors to the response increases).  (+info)

Electromyographic assessment of neuromuscular block at the gastrocnemius muscle. (4/235)

We have assessed neuromuscular block electromyographically at the gastrocnemius muscle and compared it with that at the abductor digiti minimi muscle in 60 adult patients undergoing cervical spine surgery under general anaesthesia. All patients were in the prone position. After vecuronium 0.2 mg kg-1, times to onset of neuromuscular block at the gastrocnemius and abductor digiti minimi muscles were mean 147 (SD 24) and 145 (14) s, respectively (ns). Times to return of the first response of the post-tetanic count (PTC1) at the gastrocnemius and abductor digiti minimi muscles were 27.7 (5.6) and 37.0 (5.9) min, respectively (P = 0.0001). Times to return of the first response of the train-of-four (TOF) at the gastrocnemius and abductor digiti minimi muscles were 41.0 (9.1) and 49.9 (8.7) min, respectively (P = 0.01). Recovery of PTC, T1/T0 and TOF ratio at the gastrocnemius muscle were significantly faster than at the abductor digiti minimi muscle.  (+info)

Comparison of intubating conditions after rapacuronium (Org 9487) and succinylcholine following rapid sequence induction in adult patients. (5/235)

We have assessed intubating conditions provided by rapacuronium (Org 9487) and succinylcholine after rapid sequence induction of anaesthesia in adult patients undergoing elective surgery. We studied 335 patients, ASA I and II, in five centres. Two hundred and thirty-four subjects with normal body weight and 101 obese subjects were allocated randomly to one of four treatment groups differing in the neuromuscular blocking drug administered (rapacuronium 1.5 mg kg-1 or succinylcholine 1 mg kg-1) and in the technique used for induction of anaesthesia (fentanyl 2-3 micrograms kg-1 with thiopental 3-6 mg kg-1 or alfentanil 20 micrograms kg-1 with propofol 1.5-2 mg kg-1). Intubation was started at 50 s by an anaesthetist blinded to the drugs used. Intubating conditions were clinically acceptable (excellent or good) in 89.4% of patients after rapacuronium and in 97.4% after succinylcholine (P = 0.004), the estimated difference being 8.1% (95% confidence interval (CI) 2.0-14.1%). Neither anaesthetic technique nor subject group had an influence on intubating conditions. After intubation, the maximum increase in heart rate averaged 23.1 (SD 25.4%) and 9.4 (26.1%) after rapacuronium and succinylcholine, respectively (P < 0.001). Pulmonary side effects (bronchospasm and increased airway pressure) were observed in 10.7% (95% CI 5.8-17%) and 4.1% (95% CI 1.3-8.8%) of patients given rapacuronium and succinylcholine, respectively (P = 0.021). We conclude that after rapid sequence induction of anaesthesia in adults, clinically acceptable intubating conditions were achieved less frequently after rapacuronium 1.5 mg kg-1 than after succinylcholine.  (+info)

Rapid and reversible effects of activity on acetylcholine receptor density at the neuromuscular junction in vivo. (6/235)

Quantitative fluorescence imaging was used to study the regulation of acetylcholine receptor (AChR) number and density at neuromuscular junctions in living adult mice. At fully functional synapses, AChRs have a half-life of about 14 days. However, 2 hours after neurotransmission was blocked, the half-life of the AChRs was now less than a day; the rate was 25 times faster than before. Most of the lost receptors were not quickly replaced. Direct muscle stimulation or restoration of synaptic transmission inhibited this process. AChRs that were removed from nonfunctional synapses resided for hours in the perijunctional membrane before being locally internalized. Dispersed AChRs could also reaggregate at the junction once neurotransmission was restored. The rapid and reversible alterations in AChR density at the neuromuscular junction in vivo parallel changes thought to occur in the central nervous system at synapses undergoing potentiation and depression.  (+info)

Spontaneous or neostigmine-induced recovery after maintenance of neuromuscular block with Org 9487 (rapacuronium) or rocuronium following an initial dose of Org 9487. (7/235)

We have examined spontaneous and neostigmine-induced recovery after an initial dose of Org 9487 1.5 mg kg-1 followed by three repeat doses of Org 9487, a 30-min infusion of Org 9487 or two incremental doses of rocuronium. Mean clinical duration after incremental doses of Org 9487 0.5 mg kg-1 increased from 12.3 (SD 3.4) min to 14.0 (4.0) and 15.9 (5.9) min (P < 0.01), and after rocuronium from 14.4 (5.2) min to 19.2 (5.9) min (P < 0.01). Times for spontaneous recovery from a T1 of 25% to a TOF ratio of 0.8 after the last bolus dose of Org 9487 and after a 30-min infusion were 72.4 (16.5) and 66.1 (26.9) min compared with 36.7 (15.8) min in the group receiving reocuronium. These times were significantly reduced to 9.9 (4.5), 8.6 (6.1) and 5.7 (2.5) min, respectively, after neostigmine administration at a T1 of 25% (P < 0.05). We conclude that administration of Org 9487 by repeat bolus doses or infusion was associated with slow spontaneous recovery but neostigmine administration resulted in adequate recovery in less than 10 min.  (+info)

Anaesthesia for strabismus surgery: a regional survey. (8/235)

An increase in the demand by local surgeons for neuromuscular block during strabismus surgery, and the forced duction test in particular, led us to review the literature and conduct a regional survey of anaesthetic techniques used. A questionnaire was distributed to 379 anaesthetists in the region and 264 responses were received. The results demonstrated that 55% of paediatric patients and 66% of adult patients may have been operated on under suboptimal conditions; residual tone may have been present in the extraocular muscles during forced duction testing and strabismus correction.  (+info)

Prevalence: Delayed emergence from anesthesia is not uncommon, occurring in up to 20% of all anesthesia cases. The risk of delayed emergence is higher in patients with pre-existing medical conditions, such as heart disease or obesity.

Causes: There are several possible causes of delayed emergence from anesthesia, including:

1. Difficulty in weaning the patient off the anesthetic drugs.
2. Respiratory depression or other respiratory complications.
3. Inadequate pain management.
4. Sepsis or other systemic infections.
5. Coagulopathy or bleeding disorders.
6. Pre-existing medical conditions, such as heart disease or obesity.
7. Medications taken before the procedure.
8. Poor patient positioning during the procedure.
9. Inadequate monitoring of vital signs.
10. Anesthesia technique and choice of anesthetic agents.

Signs and Symptoms: Delayed emergence from anesthesia can be characterized by a range of signs and symptoms, including:

1. Prolonged unresponsiveness to stimuli.
2. Slow return of consciousness.
3. Confusion or disorientation upon regaining consciousness.
4. Delirium or hallucinations.
5. Increased heart rate and blood pressure.
6. Decreased respiratory rate.
7. Blue tinge to the skin (cyanosis).
8. Abnormal liver function test results.
9. Elevated white blood cell count.
10. Low body temperature.

Diagnosis: The diagnosis of delayed emergence from anesthesia is based on a combination of clinical signs and symptoms, as well as laboratory tests and imaging studies. The anesthesiologist will perform a thorough physical examination and ask questions about the patient's medical history to identify any potential causes of the delayed emergence. Laboratory tests may be ordered to check for signs of infection or other complications, while imaging studies such as CT scans or MRI scans may be used to evaluate the brain for any structural abnormalities.

Treatment: Treatment of delayed emergence from anesthesia is aimed at addressing the underlying cause and supporting the patient until they fully recover. This may include:

1. Oxygen therapy to help maintain adequate oxygenation of the body's tissues.
2. Pain management medications to alleviate any discomfort or pain.
3. Antibiotics to treat any infections that may have developed.
4. Supportive care, such as fluid replacement and monitoring of vital signs.
5. In some cases, the anesthesiologist may choose to use a different type of anesthesia or sedative to help the patient emerge more quickly.

Prognosis: The prognosis for patients who experience delayed emergence from anesthesia is generally good, especially if the underlying cause can be identified and treated promptly. However, in some cases, delayed emergence may be a sign of a more serious complication, such as brain damage or infection, which can have long-term consequences.

Prevention: Preventing delayed emergence from anesthesia is not always possible, but there are steps that can be taken to minimize the risk. These include:

1. Using a balanced anesthesia plan that takes into account the patient's medical history and other factors.
2. Monitoring the patient closely during the procedure and immediately after recovery.
3. Ensuring that the patient is properly positioned and has adequate oxygenation and ventilation.
4. Avoiding over-sedation, which can increase the risk of delayed emergence.
5. Using appropriate doses of anesthesia and sedatives, and avoiding high doses whenever possible.

1. Complete paralysis: When there is no movement or sensation in a particular area of the body.
2. Incomplete paralysis: When there is some movement or sensation in a particular area of the body.
3. Localized paralysis: When paralysis affects only a specific part of the body, such as a limb or a facial muscle.
4. Generalized paralysis: When paralysis affects multiple parts of the body.
5. Flaccid paralysis: When there is a loss of muscle tone and the affected limbs feel floppy.
6. Spastic paralysis: When there is an increase in muscle tone and the affected limbs feel stiff and rigid.
7. Paralysis due to nerve damage: This can be caused by injuries, diseases such as multiple sclerosis, or birth defects such as spina bifida.
8. Paralysis due to muscle damage: This can be caused by injuries, such as muscular dystrophy, or diseases such as muscular sarcopenia.
9. Paralysis due to brain damage: This can be caused by head injuries, stroke, or other conditions that affect the brain such as cerebral palsy.
10. Paralysis due to spinal cord injury: This can be caused by trauma, such as a car accident, or diseases such as polio.

Paralysis can have a significant impact on an individual's quality of life, affecting their ability to perform daily activities, work, and participate in social and recreational activities. Treatment options for paralysis depend on the underlying cause and may include physical therapy, medications, surgery, or assistive technologies such as wheelchairs or prosthetic devices.

Respiratory alkalosis can occur due to various causes such as hypoventilation (breathing too slowly), hypercapnia (excessive carbon dioxide in the blood), bicarbonate therapy, or drinking excessive amounts of antacids. Symptoms may include vomiting, abdominal pain, headache, and muscle weakness.

Treatment typically involves addressing the underlying cause, such as correcting hypoventilation or removing excess carbon dioxide from the bloodstream. In severe cases, medications or mechanical ventilation may be necessary.

1. Infection: Bacterial or viral infections can develop after surgery, potentially leading to sepsis or organ failure.
2. Adhesions: Scar tissue can form during the healing process, which can cause bowel obstruction, chronic pain, or other complications.
3. Wound complications: Incisional hernias, wound dehiscence (separation of the wound edges), and wound infections can occur.
4. Respiratory problems: Pneumonia, respiratory failure, and atelectasis (collapsed lung) can develop after surgery, particularly in older adults or those with pre-existing respiratory conditions.
5. Cardiovascular complications: Myocardial infarction (heart attack), cardiac arrhythmias, and cardiac failure can occur after surgery, especially in high-risk patients.
6. Renal (kidney) problems: Acute kidney injury or chronic kidney disease can develop postoperatively, particularly in patients with pre-existing renal impairment.
7. Neurological complications: Stroke, seizures, and neuropraxia (nerve damage) can occur after surgery, especially in patients with pre-existing neurological conditions.
8. Pulmonary embolism: Blood clots can form in the legs or lungs after surgery, potentially causing pulmonary embolism.
9. Anesthesia-related complications: Respiratory and cardiac complications can occur during anesthesia, including respiratory and cardiac arrest.
10. delayed healing: Wound healing may be delayed or impaired after surgery, particularly in patients with pre-existing medical conditions.

It is important for patients to be aware of these potential complications and to discuss any concerns with their surgeon and healthcare team before undergoing surgery.

al Ahdal O, Bevan DR (1995). "Clindamycin-induced neuromuscular blockade". Can J Anaesth. 42 (7): 614-7. doi:10.1007/BF03011880 ... Sloan PA, Rasul M (2002). "Prolongation of rapacuronium neuromuscular blockade by clindamycin and magnesium". Anesth Analg. 94 ... Fogdall RP, Miller RD (1974). "Prolongation of a pancuronium-induced neuromuscular blockade by clindamycin". Anesthesiology. 41 ... Clindamycin may prolong the effects of neuromuscular-blocking drugs, such as succinylcholine and vecuronium. Its similarity to ...
... neuromuscular blockade); Wellferon (Hepatitis B&C); Zolmitriptan (anti migraine); plus an extensive range of over-the-counter ...
Analgesia Neuromuscular Blockade Working Group (2006). "Consensus guidelines on sedation and analgesia in critically ill ...
... is a muscle relaxant through neuromuscular blockade. It is excreted entirely through the kidneys and therefore ...
Durham, Mark; Westhead, Pete; Griffiths, David; Lyon, Richard; Lau-Walker, Margaret (2020). "Prehospital neuromuscular blockade ...
... , sold under the brand name Bridion, is a medication for the reversal of neuromuscular blockade induced by rocuronium ... It found that sugammadex provides a rapid and dose-dependent reversal of neuromuscular blockade induced by high-dose rocuronium ... The British Journal of Anaesthesia published an article in 2015 in which the incidence of residual neuromuscular blockade could ... Sugammadex is indicated for the reversal of neuromuscular blockade induced by rocuronium or vecuronium. Sugammadex is a ...
... is toxic after parenteral administration, producing symptoms of neuromuscular blockade; further details are given in ... and it was a neuromuscular blocker of the depolarizing type. In many of these respects, candicine resembled nicotine and ... that the effects on frog tissue of candicine most closely resembled those of the well-known depolarizing neuromuscular-blocking ...
Another possible complication is anaphylaxis in response to a neuromuscular blockade. Neuromuscular blockade agents are ... Administration of induction agents followed by neuromuscular blockade agents helps to achieve optimal conditions for intubation ... "Neuromuscular Blockade", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 30855885, retrieved 2022-11-10 Cook, ... "Neuromuscular Blockade", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 30855885, retrieved 2022-11-10 Hager, ...
The incidence is halved in the absence of neuro-muscular blockade. The quoted incidences are controversial as many cases of " ... Risk factors for intraoperative awareness include anesthetic factors (i.e. use of neuromuscular blockade drugs, use of ... If neuromuscular blocking drugs are used this causes skeletal muscle paralysis but does not interfere with cardiac or smooth ... Even without the use of neuromuscular blocking drugs the absence of movement does not necessarily imply amnesia. For certain ...
Camu F, D'Hollander A (1978). "Neuromuscular blockade of fazadinium bromide (AH 8165) in renal failure patients". Acta ... bromide is a muscle relaxant which acts as a nicotinic acetylcholine receptor antagonist through neuromuscular blockade. ...
Titiz, Izzet; Ozel; Ozel; Toros; Marur; Yildirim; Erdogdu; Kara (19 August 2010). "Denervation Point for Neuromuscular Blockade ... Blockade of the lateral pectoral nerve is helpful in cases such as shoulder dislocation and other orthopedic procedures, ... Decreasing the pectoral muscle tone intraoperatively by neuromuscular relaxation (paralytic agents) or by a nerve block (local ... may be reduced by pectoral nerve block or neuromuscular relaxation. ...
Less frequent side effects include neuromuscular blockade, facial edema, and peripheral neuropathy. The half-life in most ... Amikacin can cause neuromuscular blockade (including acute muscular paralysis) and respiratory paralysis (including apnea). ... Amikacin should not be used with neuromuscular blocking agents, as they can increase muscle weakness and paralysis. Amikacin ... The effect of amikacin is increased when used with drugs derived from the botulinum toxin, anesthetics, neuromuscular blocking ...
Nondepolarizing neuromuscular blocking agents, such as vecuronium bromide: Neuromuscular blockade is potentiated. CNS ... or proper neuromuscular balance If the indication is a medical emergency, such as malignant hyperthermia, the only significant ...
This toxin causes a neuromuscular blockade by blocking the nicotinic acetylcholine receptor. It is the most abundant component ... "Neuromuscular activity of the venoms of the Colombian coral snakes Micrurus dissoleucus and Micrurus mipartitus: An ...
Neuromuscular function monitoring, preferably quantitative, must be available for every patient in whom neuromuscular blockade ... When neuromuscular blocking agents are administered, neuromuscular function of the patient must be monitored. Neuromuscular ... devices that provide a numeric value relating to the depth of neuromuscular blockade. Quantitative neuromuscular monitors can ... It may be used from the induction of to recovery from neuromuscular blockade. Importantly, it is used to confirm adequacy of ...
"Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient". Critical Care Medicine ... Depolarizing neuromuscular blocking agents, most notably succinylcholine, can worsen increased ICP due to induction of muscle ... Pretreatment with a sedative agent and neuromuscular blocking agent to induce unconsciousness and motor paralysis has been ...
Neuromuscular blockade can lead to skeletal muscle weakness and respiratory depression or paralysis (apnea). Using anti- ... Combined with anti-neuromuscular block drugs: can antagonize the effect of the anti-neuromuscular block drugs on the skeletal ... Combined with methoxyflurane or polymyxin injection: may increase renal toxicity or neuromuscular blockade effect. Combined ... neuromuscular blockade, renal toxicity, hypokalemia), nausea or vomiting. Significant renal toxicity: blood creatinine increase ...
Neuromuscular block-ade improves surgical conditions (NISCO). Surg Endosc.2015;29:627-636. Brull, Sorin; Naguib, Mohamed. " ... Neuromuscular Block Monitoring in Patients With Facial Rejuvenation: A Case Report. A A Pract. 2020;14(13):e01334. doi:10.1213/ ... Neuromuscular blocking agents, or in abbreviation, NMBAs, are chemical agents that paralyse skeletal muscles by blocking the ... Neuromuscular blocking agents exert its effect by modulating the signal transmission in skeletal muscles. An action potential ...
Alauddin, M.; Caddy, B.; Lewis, J.J.; Martin-Smith, M.; Sugrue, M.F. (January 1965). "Non-depolarising neuromuscular blockade ... Malouetine is an aminosteroid neuromuscular blocking agent and antinicotinic alkaloid isolated from Malouetia spp. The ... Neuromuscular blockers, Quaternary ammonium compounds, All stub articles, Steroid stubs, Musculoskeletal system drug stubs). ... "Pancuronium bromide and other steroidal neuromuscular blocking agents containing acetylcholine fragments". Journal of Medicinal ...
The greatest frequency of drug-induced neuromuscular blockade was seen with aminoglycoside-induced postoperative respiratory ... Neuromuscular junction disease is a medical condition where the normal conduction through the neuromuscular junction fails to ... The neuromuscular junction is a specialized synapse between a neuron and the muscle it innervates. It allows efferent signals ... In the neuromuscular junction, the diseases will either act on the presynaptic membrane of the motor neuron, the synapse ...
The decrease must be greater than 75% before significant prolongation of neuromuscular blockade occurs with succinylcholine. In ... For example, in muscle contraction, acetylcholine at a neuromuscular junction triggers a contraction; but for the muscle to ... in neuromuscular junctions, and in other neural synapses. Acetylcholinesterase exists in multiple molecular forms. In the ...
... a rare genetic condition leading to prolonged duration of neuromuscular blockade, which can range from 20 minutes to a number ... Atracurium and Mivacurium Anaphylaxis Another potentially disturbing complication where neuromuscular blockade is employed is ' ... neuromuscular disease and paralyzed (quadriplegic, paraplegic) patients. The mechanism is reported to be through upregulation ...
... reduces plasma pseudocholinesterase activity and may result in prolonged neuromuscular blockade when ... Vigouroux D, Voltaire L (1995). "[Prolonged neuromuscular block induced by mivacurium in a patient treated with ... cyclophosphamide]" [Prolonged neuromuscular block induced by mivacurium in a patient treated with cyclophosphamide]. Annales ...
Small degrees of muscle blockade can only accurately be measured by the use of quantitative neuromuscular monitoring. ... to measure the depth of neuromuscular blockade and to assess adequacy of recovery from these agents at the end of surgery. ... Muscle relaxant Myograph Neuromuscular-blocking drug Neuromuscular monitoring Brull SJ, Murphy GS (July 2010). "Residual ... Longer-acting drugs have higher prevalence of residual blockade in the PACU or ICU than shorter acting drugs. Different ...
The drug may also be used for reversal of neuromuscular blockade at the end of a surgical procedure. Edrophonium, ethyl-(3- ... In this instance reversal of paralysis will not occur until the damaged terminal axons at the neuromuscular junction have ... In a cholinergic crisis, where a person has too much neuromuscular stimulation, edrophonium will make the muscle weakness worse ... mainly at the neuromuscular junction. It is sold under the trade names Tensilon and Enlon (according to FDA Orange Book). ...
This neuromuscular blockade permitted complete paralysis of the diaphragm and enabled control of ventilation via positive ... in order to induce a state of unconsciousness and partial neuromuscular blockade. The exact composition of mafeisan, similar to ...
Blockade of neuromuscular transmission by huwentoxin-I, purified from the venom of the Chinese bird spider Selenocosmia huwena ... Both HWTX-VII and HWTX-VIII block neuromuscular transmission in the isolated mouse phrenic nerve-diaphraghm preparation and act ... HWTX-II blocks neuromuscular transmission in the isolated mouse nerve diaphragm preparation and acts cooperatively to ...
Those that inhibit neurotransmitter release create a neuromuscular blockade that prevents signaling molecules from reaching ... Not all species use a cholinergic neuromuscular junction; e.g. crayfish and fruit flies have a glutamatergic neuromuscular ... resulting in a neuromuscular blockade, similar to the effects seen due to presynaptic neurotoxins. This causes paralysis in the ... A neuromuscular junction (or myoneural junction) is a chemical synapse between a motor neuron and a muscle fiber. It allows the ...
... but gradually decrease in case of neuromuscular blockade. It is recommended during use of continuous-infusion neuromuscular ... Neuromuscular-blocking drugs block neuromuscular transmission at the neuromuscular junction, causing paralysis of the affected ... With no neuromuscular blockade, the resultant muscle contractions are of equal strength, ... A neuromuscular non-depolarizing agent is a form of neuromuscular blocker that does not depolarize the motor end plate. The ...
"Efficacy and safety of sugammadex compared to neostigmine for reversal of neuromuscular blockade: a meta-analysis of randomized ... The neuromuscular blocking action of vecuronium is slightly enhanced in the presence of potent inhalation anesthetics. If ... Vecuronium is in the aminosteroid neuromuscular-blocker family of medications and is of the non-depolarizing type. It works by ... Neuromuscular blockers, Nicotinic antagonists, Piperidines, Quaternary ammonium compounds, Wikipedia medicine articles ready to ...
Cholinesterase Inhibitors & Other Pharmacologic Antagonists to Neuromuscular Blocking Agents.". Morgan & Mikhail's Clinical ... are used in the treatment of myasthenia gravis and in anaesthesia to reverse muscle blockade. The carbamate pesticides are also ...
The mechanism of ball-and-chain inactivation is also distinct from that of voltage-dependent blockade by intracellular ... Differences in persistent and resurgent currents have been implicated in certain human neurological and neuromuscular disorders ... Choi KL, Aldrich RW, Yellen G (1991). "Tetraethylammonium blockade distinguishes two inactivation mechanisms in voltage- ...
Neuromuscular disease Online Mendelian Inheritance in Man (OMIM): 600882 Charcot-Marie-Tooth Disease, Axonal, Type 2B; CMT2B - ... "An epigenetic blockade of cognitive functions in the neurodegenerating brain". primary. Nature. 483 (7388): 222-6. Bibcode: ... Quisinostat (JNJ-26481585) Quisinostat is effective at low doses resulting in some improved neuromuscular function in mouse ... Myasthenia gravis is an autoimmune disease affecting synapses at the neuromuscular junction, whereby antibodies produced ...
... and blockade of GAT protein-mediated glial GABA uptake, making it a putative "small molecule neurotransmitter." There is ... and helps delay the onset of neuromuscular fatigue. Ingestion of β-alanine can cause paraesthesia, reported as a tingling ...
Thirdly, the use of neuromuscular blockades is a risk factor of AAGA and also hinders communication of distress in the case of ...
... is another method of delivering sphenopalatine blockade and indirect stellate ganglion blockade. Complications associated with ... Shapira, Ira L. (11 April 2019). "Neuromuscular dentistry and the role of the autonomic nervous system: Sphenopalatine ganglion ... Sympathetic Neural Blockade", Pain Procedures in Clinical Practice (Third Edition), Saint Louis: Hanley & Belfus, pp. 507-519, ...
Satoyoshi syndrome Hyperekplexia Darras, Basil T.; Jones, H. Royden Jr.; Ryan, Monique M. (3 December 2014). Neuromuscular ... causing a functional blockade with gamma-aminobutyric acid. This leads to GABA impairment, which probably causes the stiffness ...
... neuromuscular blockade and delirium assessment in adult intensive care units in Singapore". Crit Care & Shock. 13: 122-131.{{ ...
It acts by blocking nerve function (neuromuscular blockade) through inhibition of the excitatory neurotransmitter ... This prevents additional toxin from binding to the neuromuscular junction, but does not reverse any already inflicted paralysis ... After this time, paralysis generally improves as new neuromuscular connections are formed. In some abdominal cases, physicians ... Myoneural junction and neuromuscular diseases, Poultry diseases, Wikipedia infectious disease articles ready to translate, ...
Potassium channel blockade has the effect of increasing axonal action potential propagation and improving the probability of ... A study has shown that 4-AP is a potent calcium channel activator and can improve synaptic and neuromuscular function by ... prolonging action potentials and thereby increasing neurotransmitter release at the neuromuscular junction. The drug has been ... "Aminopyridines Potentiate Synaptic and Neuromuscular Transmission by Targeting the Voltage-activated Calcium Channel β Subunit ...
The degree of neuronal blockade depends on the amount and concentration of local anaesthetic used and the properties of the ... An epidural often does not cause as significant a neuromuscular block as a spinal, unless specific local anaesthetics are also ... Spinal anesthesia may be favored when the surgical site is amenable to spinal blockade for patients with severe respiratory ... A pressure sensation is permissible and often occurs due to incomplete blockade of the thicker A-beta mechanoreceptors. This ...
Interestingly, the use of sugammadex to reverse neuromuscular blockade (the mechanism of paralysis during surgery) has also ...
Blockade of RYR1 by dantrolene prevents adverse reaction to halothane in these mice, as with humans. Muscle from these mice ... muscle weakness and prolonged duration of action of nondepolarizing neuromuscular blocking agents), experts no longer recommend ...
... are at risk of adverse events associated with undetected residual neuromuscular blockade. Neuromuscular function monitoring and ... It produces a neuromuscular blockade that is the fastest in onset and has the shortest duration of all NMBDs. Due to these ... Today residual neuromuscular blockade is defined as a train of four ratio of less than 0.9 when measuring the response to ulnar ... Postoperative residual curarization (PORC) or residual neuromuscular blockade (RNMB) is a residual paresis after emergence from ...
This lethal effect is the result of a presynaptic blockade of transmission across neuromuscular junctions of the breathing ... Oh SJ (2022-01-01). "19 - Treatment and Management of Disorders of the Neuromuscular Junction". In Bertorini TE, Oh SJ (eds.). ... Neuromuscular Disorders (Second ed.). St. Louis (MO): Elsevier. pp. 446-491. doi:10.1016/B978-0-323-71317-7.00019-6. ISBN 978-0 ... venom at the mammalian neuromuscular junction". British Journal of Pharmacology. 47 (1): 141-146. doi:10.1111/j.1476-5381.1973. ...
Type IA and IIA block the presynaptic calcium channels in the presynaptic terminals of the neuromuscular junction of insects. ... Their mechanism of action includes blockade of glutamate-gated ion channels, voltage-gated sodium channels, or voltage- ... Thereby, type IIA can also block the presynaptic calcium channels in neuromuscular junction of vertebrates. Type IIIA blocks ... Mu-agatoxin: is a specific modifier for sodium channels (presynaptic voltage-activated sodium channels), in the neuromuscular ...
When there is a blockade of expression of the CTLA-4 region, as is seen in those with MG, increased T-cell activation occurs ... which recruits the immune system to destroy the ACh receptors present at neuromuscular junctions. A significantly higher levels ...
Brachial plexus blockade may be a reasonable option when all of the following criteria are met:[citation needed] Surgery is ... Continuous wound infiltration Drug-induced amnesia Neuromuscular monitoring Suprascapular nerve Panchamia, Jason, Olsen, David ... Combined Selective Nerve Blockade and Local Infiltration Analgesia in a Total Shoulder Arthroplasty Patient With Chronic Pain ... There are multiple approaches to blockade of the brachial plexus, beginning proximally with the interscalene block and ...
C-toxiferine I itself has been tested for its pharmacological action and noted to be a very long acting neuromuscular blocking ... The major disadvantage of alcuronium is that it elicits a vagolytic effect produced by a selective atropine-like blockade of ... Alcuronium chloride (formerly marketed as Alloferin) is a neuromuscular blocking (NMB) agent, alternatively referred to as a ... Hughes R, Chapple DJ (1976). "Effects of Non-Depolarizing Neuromuscular Blocking Agents on Peripheral Autonomic Mechanisms in ...
Then in the twentieth century neuromuscular blockade allowed the anesthesiologist to completely paralyze the patient ... neuromuscular monitoring, cortical stimulation mapping, and neuromorphology Mechanical ventilation Anatomical knowledge of the ...
Succinylcholine duration is usually on the order of 7-15 minutes and the extent of blockade is monitored with a neuromuscular ... the heterozygous and mutant homozygous individual will experience a prolonged duration of action of neuromuscular blockade. ... of dibucaine number is a cost-effective method of identifying patients at increased risk of prolonged neuromuscular blockade ... When given succinylcholine, a commonly used neuromuscular-blocking drug administered for general anesthesia during surgery, ...
... N Engl J Med. 2019 May 23;380(21):1997-2008. doi: ... Background: The benefits of early continuous neuromuscular blockade in patients with acute respiratory distress syndrome (ARDS ... or to a usual-care approach without routine neuromuscular blockade and with lighter sedation targets (control group). The same ... in the control group received a neuromuscular blocking agent (median dose, 38 mg). At 90 days, 213 patients (42.5%) in the ...
SEARCH RESULTS for: Neuromuscular Nondepolarizing Blockade [Drug Class] (77 results) *Share : JavaScript needed for Sharing ...
... a Quantitative Neuromuscular Monitor used by Anesthesia providers to asses neuromuscular blockade. ... 2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade. ... The Clinically Validated Neuromuscular Monitor. Quantitative train of four (TOF) monitoring eliminates the guesswork in the ... assessment of neuromuscular block. Validated accurate electromyography (EMG) based monitoring with TwitchView can effectively ...
SEARCH RESULTS for: Neuromuscular Depolarizing Blockade [Drug Class] (48 results) *Share : JavaScript needed for Sharing tools ...
I discuss reversal of neuromuscular blockade. This is a follow up to episode 66 in which I covered neuromuscular blockade. ... Reversal (Antagonism) of Neuromuscular Blockade. Murphy GS, de Boer HD, Eriksson LI and Miller RD. Chapter 35, 995-1027.e5. ... Episode 77: Reversal of Neuromuscular Blockade. March 28, 2018. ACCRAC 15 Comments ... Sugammadex: A Review of Neuromuscular Blockade Reversal. Drugs. 2016 Jul;76(10):1041-52. ...
... to reverse the effects of the neuromuscular blocking drugs rocuronium bromide and vecuronium bromide. The drugs are used to ... FDA Approves Sugammadex for Reversing Neuromuscular Blockade. Published on: December 18th, 2015. ... The FDA has approved sugammadex (Bridion; Merck Sharp and Dohme Corp.) to reverse the effects of the neuromuscular blocking ...
Recovery from the effects of non-depolarising relaxants can occur spontaneously by elimination of the agent either unchanged or after metabolism in general anaesthesia. However, this process may be slow, of variable time and cannot be reliably predicted. It may result in residual curarization. Also, surgical procedures can be of unpredictable duration and may require intense relaxation until near the completion of surgery. Pharmacological antagonism or reversal of NM block is therefore indicated in clinical practice. This can be accomplished with a variety of drugs called as reversal agents.. ...
Neuromuscular blockade is associated with the attenuation of biomarkers of epithelial and endothelial injury in patients with ... Neuromuscular blockade is associated with the attenuation of biomarkers of epithelial and endothelial injury in patients with ... BACKGROUND: Neuromuscular blockade (NMB) is a therapy for acute respiratory distress syndrome (ARDS). However, the mechanism by ... Home Publications Neuromuscular blockade is associated with the attenuation of biomarkers of epithelial and endothelial injury ...
We performed a clinical study to establish the influence of moderate and deep neuromuscular blockade (NMB) on the abdominal ... MRI measurement of the effects of moderate and deep neuromuscular blockade on the abdominal working space during laparoscopic ... Conflicting data exist regarding the effects of deep neuromuscular blockade (NMB) on abdominal dimensions during laparoscopic ... MRI measurement of the effects of moderate and deep neuromuscular blockade on the abdomina ...
Neuromuscular Blockade: Patients with neuromuscular disorders were not enrolled in ARIKAYCE clinical trials. Patients with ... known or suspected neuromuscular disorders, such as myasthenia gravis, should be closely monitored since aminoglycosides may ... aggravate muscle weakness by blocking the release of acetylcholine at neuromuscular junctions. ...
... neuromuscular blockade. We conclude that neuromuscular blockade does not affect the efficiency of mask ventilation in patients ... tidal volumes before and after neuromuscular blockade in 30 patients undergoing general anaesthesia. The ratio V(TE)/V(TI) was ... Thirty per cent of respondents always checked mask ventilation before administering a neuromuscular blocking drug, whereas 39% ... We conducted a two-part study to assess the practice of withholding neuromuscular blockade until the ability to ventilate the ...
Infants are more sensitive to neuromuscular blockade activity and, although the same dose is used, recovery is prolonged by 50 ... Neuromuscular Blockers, Depolarizing. Class Summary. To control hyperreflexia, clonus, and hyperthermia, total neuromuscular ... Benzodiazepines are considered a mainstay of serotonin syndrome (SS) treatment, particularly as a therapy for neuromuscular ... Rocuronium is a nondepolarizing neuromuscular blocking agent with rapid to intermediate onset (depending on dose) and ...
Transient neuromuscular blockade.. Infusion of ,200 mg/min in adults can rarely cause respiratory or cardiac arrest. (Howland ...
Depolarizing neuromuscular blockade. - Cholinesterase inhibition. - Increased cell membrane permeability, resulting in ...
Neuromuscular Blockade Reversal. Prevention of muscarinic adverse effects. 0.2 mg IV per 1 mg of neostigmine or 5 mg of ... Neuromuscular Blockade Reversal. 0.2 mg IV per 1 mg of neostigmine or 5 mg of pyridostigmine administered ...
Bispectral Index for Titrating Sedation in ARDS Patients During Neuromuscular Blockade CE Article ... Bispectral Index for Titrating Sedation in ARDS Patients During Neuromuscular Blockade. Am J Crit Care 1 September 2019; 28 (5 ... during the first 24 hours of neuromuscular blockade, but this was not associated with any difference in clinical outcomes. ... Daily sedation and analgesia while a neuromuscular blocking agent was being administered were compared between patients with ...
Monitoring neuromuscular blockade and depth of anaesthesia. Anaesthesia and Intensive Care Medicine 12(6), pp. 271-274. ( ... Monitoring neuromuscular blockade and depth of anaesthesia. Anaesthesia and Intensive Care Medicine 12(6), pp. 271-274. ( ... Thomas G, Morgan M. Monitoring neuromuscular blockade and depth of anaesthesia. Anaesthesia & Intensive Care Medicine. 2011 Jun ...
Baudax Bio reports promising additional data for neuromuscular blockade agent News Baudax Bio reports promising additional data ...
Module 6: Neuromuscular Blockades *Module 7: Blood and Fluid Therapy *Module 8: Regional and Neuraxial Anesthetic Agents ...
Panel on Monitoring of Neuromuscular Blockade at 2012 New York PGA Meeting, Sponsored by APSF. Robert C. Morell, MD On Monday, ... Panel on Monitoring of Neuromuscular Blockade at 2012 New York PGA Meeting, Sponsored by APSF ...
If neuromuscular blockade occurs, calcium salts may reverse it.. Although the in vitro mixing of gentamicin and carbenicillin ... Neuromuscular blockade and respiratory paralysis have been reported in the cat receiving high doses (40 mg/kg) of gentamicin. ... The potential toxic effects of antibiotics administered in this fashion (neuromuscular blockade, respiratory paralysis, oto- ... Aminoglycosides should be used with caution in patients with neuromuscular disorders such as myasthenia gravis or parkinsonism ...
Monitor for signs and symptoms of prolonged neuromuscular blockade. Drugs with Absorption Altered due to Increased ...
Possible prolonged neuromuscular blockade due to change of the characteristic depolarizing neuromuscular block (phase I block) ... Assess neuromuscular blockade and recovery in patients undergoing anesthesia; careful assessment with a peripheral nerve ... Possible prolonged neuromuscular blockade in patients with electrolyte disturbances (e.g., hypocalcemia, hypokalemia). Use with ... Also used to facilitate mechanical ventilation; however, not used for prolonged neuromuscular blockade in the ICU. ...
Clinician recognition of ARDS was associated with higher PEEP, greater use of neuromuscular blockade, and prone positioning. ...
to prolonged neuromuscular blockade after the use of succinylcholine. Genet Mol Biol. 2011 Jan;34(1):40- ... with prolonged ... Pregnancy and Childbirth with Neuromuscular Disease (Muscular Dystrophy Association) - PDF Neuromuscular Disorders/Women ... ...
  • Schaller S, Fink H. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review. (
  • Galantamine has an extensive record of activity as a reversal agent for neuromuscular blockade. (
  • McLean DJ, Diaz-Gil D, Farhan HN, Ladha KS, Kurth T, Eikermann M. Dose-dependent Association between Intermediate-acting Neuromuscular-blocking Agents and Postoperative Respiratory Complications. (
  • Should be administered only by individuals experienced in the use of neuromuscular blocking agents. (
  • The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. (
  • Subsequent neuromuscular transmission is inhibited so long as adequate concentration of succinylcholine remains at the receptor site. (
  • Chronically administered oral contraceptives, glucocorticoids, or certain Monoamine Oxidase Inhibitors: The neuromuscular blocking effect of succinylcholine may be enhanced by drugs that reduce plasma cholinesterase activity. (
  • Rapid neuromuscular blockade: are there alternatives to succinylcholine? (
  • The benefits of early continuous neuromuscular blockade in patients with acute respiratory distress syndrome (ARDS) who are receiving mechanical ventilation remain unclear. (
  • Neuromuscular blockade is associated with the attenuation of biomarkers of epithelial and endothelial injury in patients with moderate-to-severe acute respiratory distress syndrome. (
  • BACKGROUND: Neuromuscular blockade (NMB) is a therapy for acute respiratory distress syndrome (ARDS). (
  • 2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade. (
  • Reversal (Antagonism) of Neuromuscular Blockade. (
  • Hristovska AM, Duch P, Allingstrup M, Afshari A. Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults. (
  • Sugammadex: A Review of Neuromuscular Blockade Reversal. (
  • 19. Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults. (
  • Depolarizing neuromuscular blocking agent. (
  • Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. (
  • Careful intraoperative management of neuromuscular blockade may optimize patient recovery and improve postoperative outcomes. (
  • In regards to deciding which anti-cholinergic to match with which anti-cholinesterase to reverse neuromuscular blocking drugs, you specifically mention onset of action -atropine with edrophonium / glycopyrrolate with neostigmine. (
  • because of its rapid onset and short duration of action, generally considered neuromuscular blocking agent of choice in emergency situations when rapid intubation (e.g., rapid sequence intubation) is required. (
  • median dose, 1807 mg), and 86 of the 505 patients (17.0%) in the control group received a neuromuscular blocking agent (median dose, 38 mg). (
  • We conducted a two-part study to assess the practice of withholding neuromuscular blockade until the ability to ventilate the lungs using a bag and face mask (mask ventilation) has been established following induction of anaesthesia. (
  • Recommended by ASA Neuromuscular Monitoring Guidelines. (
  • Quantitative train of four (TOF) monitoring eliminates the guesswork in the assessment of neuromuscular block. (
  • Merck Sharp and Dohme Corp.) to reverse the effects of the neuromuscular blocking drugs rocuronium bromide and vecuronium bromide. (
  • careful assessment with a peripheral nerve stimulator is recommended during continuous IV infusions to monitor the degree of neuromuscular blockade, to detect the development of phase II block, and to minimize the possibility of overdosage. (
  • It is distinguished from NERVE BLOCK in which nerve conduction ( NEURAL CONDUCTION ) is interrupted rather than neuromuscular transmission. (
  • Galantamine is a useful agent for the treatment of Alzheimer disease and for the reversal of neuromuscular blockade. (
  • The failure of neuromuscular transmission as a result of pathological processes is not included here. (
  • MRI measurement of the effects of moderate and deep neuromuscular blockade on the abdominal working space during laparoscopic surgery, a clinical study. (
  • Conflicting data exist regarding the effects of deep neuromuscular blockade (NMB) on abdominal dimensions during laparoscopic procedures . (
  • Appiah-Ankam J, Hunter J. Pharmacology of neuromuscular blocking drugs. (
  • Thirty per cent of respondents always checked mask ventilation before administering a neuromuscular blocking drug, whereas 39% of respondents (all them consultants) never did this. (
  • In the second part of the study, we measured inspired (V(TI)) and expired (V(TE)) tidal volumes before and after neuromuscular blockade in 30 patients undergoing general anaesthesia. (
  • We conclude that neuromuscular blockade does not affect the efficiency of mask ventilation in patients with normal airways. (
  • We performed a clinical study to establish the influence of moderate and deep neuromuscular blockade (NMB) on the abdominal working space, measured by Magnetic Resonance Imaging (MRI), during laparoscopic donor nephrectomy with standard pressure (12 mmHg) pneumoperitoneum under sevoflurane anaesthesia. (

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