Succinylcholine: 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.Neuromuscular Depolarizing Agents: 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.Neuromuscular Blocking Agents: 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.Neuromuscular Nondepolarizing Agents: 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.Vecuronium Bromide: 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.Androstanols: Androstanes and androstane derivatives which are substituted in any position with one or more hydroxyl groups.Fasciculation: Involuntary contraction of the muscle fibers innervated by a motor unit. Fasciculations can often by visualized and take the form of a muscle twitch or dimpling under the skin, but usually do not generate sufficient force to move a limb. They may represent a benign condition or occur as a manifestation of MOTOR NEURON DISEASE or PERIPHERAL NERVOUS SYSTEM DISEASES. (Adams et al., Principles of Neurology, 6th ed, p1294)Intubation, Intratracheal: 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.Pancuronium: 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.Neuromuscular Blockade: 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.CholinesterasesMalignant Hyperthermia: Rapid and excessive rise of temperature accompanied by muscular rigidity following general anesthesia.Thiopental: A barbiturate that is administered intravenously for the induction of general anesthesia or for the production of complete anesthesia of short duration.Anesthesia, IntratrachealAnesthesia, Inhalation: Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract.Tubocurarine: A neuromuscular blocker and active ingredient in CURARE; plant based alkaloid of Menispermaceae.Anesthesia, General: Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.Ulnar Nerve: 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.Masseter Muscle: A masticatory muscle whose action is closing the jaws.Pseudocholinesterase: An aspect of cholinesterases.Muscle Rigidity: Continuous involuntary sustained muscle contraction which is often a manifestation of BASAL GANGLIA DISEASES. When an affected muscle is passively stretched, the degree of resistance remains constant regardless of the rate at which the muscle is stretched. This feature helps to distinguish rigidity from MUSCLE SPASTICITY. (From Adams et al., Principles of Neurology, 6th ed, p73)Apnea: A transient absence of spontaneous respiration.Decamethonium Compounds: Compounds that contain the decamethylenebis(trimethyl)ammonium radical. These compounds frequently act as neuromuscular depolarizing agents.Atracurium: 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.gamma-Cyclodextrins: Cyclic GLUCANS consisting of eight (8) glucopyranose units linked by 1,4-glycosidic bonds.Halothane: 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)Nitrous Oxide: 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.Butyrylcholinesterase: An aspect of cholinesterase (EC 220.127.116.11).Preanesthetic Medication: Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.Butyrylthiocholine: A sulfur-containing analog of butyrylcholine which is hydrolyzed by butyrylcholinesterase to butyrate and thiocholine. It is used as a reagent in the determination of butyrylcholinesterase activity.Neuromuscular Junction: The synapse between a neuron and a muscle.Anesthetics, Intravenous: 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)Tachyphylaxis: Rapidly decreasing response to a drug or physiologically active agent after administration of a few doses. In immunology, it is the rapid immunization against the effect of toxic doses of an extract or serum by previous injection of small doses. (Dorland, 28th ed)Propofol: 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.Laryngismus: A disorder in which the adductor muscles of the VOCAL CORDS exhibit increased activity leading to laryngeal spasm. Laryngismus causes closure of the VOCAL FOLDS and airflow obstruction during inspiration.Anesthesia: 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.Masticatory Muscles: Muscles arising in the zygomatic arch that close the jaw. Their nerve supply is masseteric from the mandibular division of the trigeminal nerve. (From Stedman, 25th ed)Anesthesia Recovery Period: The period of emergence from general anesthesia, where different elements of consciousness return at different rates.Parabens: Methyl, propyl, butyl, and ethyl esters of p-hydroxybenzoic acid. They have been approved by the FDA as antimicrobial agents for foods and pharmaceuticals. (From Hawley's Condensed Chemical Dictionary, 11th ed, p872)Laryngeal Muscles: 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).Fentanyl: 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)Preservatives, Pharmaceutical: Substances added to pharmaceutical preparations to protect them from chemical change or microbial action. They include ANTI-BACTERIAL AGENTS and antioxidants.Dibucaine: A local anesthetic of the amide type now generally used for surface anesthesia. It is one of the most potent and toxic of the long-acting local anesthetics and its parenteral use is restricted to spinal anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1006)Diaphragm: 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.Thiocholine: A mercaptocholine used as a reagent for the determination of CHOLINESTERASES. It also serves as a highly selective nerve stain.Laryngoscopy: Examination, therapy or surgery of the interior of the larynx performed with a specially designed endoscope.Anesthesia, Intravenous: Process of administering an anesthetic through injection directly into the bloodstream.Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., WOUNDS, GUNSHOT; WHIPLASH INJURIES; etc.).Spinal Cord: A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.Mobile Applications: Computer programs or software installed on mobile electronic devices which support a wide range of functions and uses which include television, telephone, video, music, word processing, and Internet service.Disease Models, Animal: Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.
Grady D. (2001-03-31). "Anesthesia drug is removed from market after the deaths of 5 patients". The New York Times. Archived ... It can also be used to help with endotracheal intubation but suxamethonium (succinylcholine) is generally preferred if this ... Indeed, because laudanosine is cleared primarily via renal excretion, a cat study modelling anephric patients went so far as to ... Yeung ML, Ng LY, Koo AW (Feb 1979). "Severe bronchospasm in an asthmatic patient following alcuronium and D-tubocurarine". ...
An IO infusion can be used on adult or pediatric patients when traditional methods of vascular access are difficult or ... and intravenous administration of succinylcholine". Pediatric Emergency Care. 5 (4): 209-210. doi:10.1097/00006565-198912000- ... 1% lidocaine is used to ease the pain associated with large volume IO infusions in conscious patients. The automatic intra- ... Day, Michael W. (April 2011). "Intraosseous Devises for Intravascular Access in Adult Trauma Patients". Critical Care Nurse. 31 ...
Some conscious patients who are administered neuromuscular blocking agents such as succinylcholine may have low bispectral ... Four studies (26,530 patients) compared BIS monitoring with end tidal anaesthetic gas (ETAG) monitoring as a guide to ... The BIS monitor thus gives the anesthetist an indication of how "deep" under anesthesia the patient is. The essence of BIS is ... "Artifact in the Bispectral Index in a Patient with Severe Ischemic Brain Injury". Anesth Analg. 98 (3): 706-7. Mar 2004. doi: ...
... in many patients; this constitutes a relative contraindication to its use in patients with myocardial ischaemia. Because of the ... Succinylcholine is a widely used muscle relaxant drug which acts by activating, instead of blocking, the ACh receptor. The ... Regardless, all in all some 30,000 patients had been given tubocurarine by 1941, although it was Griffith and Johnson's 1942 ... and became the standard anesthetic technique in England in the 1950s and 1960s for patients of all ages and physical status. ...
Information for patients with laryngospasm - voicedoctor.net Links, Information and Resources about Laryngospasm Laryngospasm ... In more severe cases it may require the administration of an intravenous muscle relaxant, such as Succinylcholine, and ... Laryngospasm in the operating room is treated by hyperextending the patient's neck and administering assisted ventilation with ... Patients who are prone to laryngospasm during illness can take measures to prevent irritation such as antacids to avoid acid ...
Even if the patient is given succinylcholine, he can be kept intubated and sedated until the muscle relaxation resolves. Drugs ... First, the patient may lie awake and paralyzed, while medical providers try to determine the cause of the patient's ... These patients also may notify others in their family who may be at risk for carrying one or more abnormal pseudocholinesterase ... If the patient is maintained on a mechanical respirator until normal breathing function returns, there is little risk of harm ...
She had used injections of digoxin, heparin, and later succinylcholine to induce medical crises in her patients, causing ... A patient cannot breathe while under the influence of this drug. In small children, cardiac arrest is the ultimate result of ... Succinylcholine is a powerful paralytic that causes temporary paralysis of all skeletal muscles, as well as those that control ... The doctor in the office discovered puncture marks in a bottle of succinylcholine in the drug storage, where only she and Jones ...
IOP is an important aspect in the evaluation of patients at risk from glaucoma. Most tonometers are calibrated to measure ... The depolarising muscle relaxant succinylcholine, which is used in anaesthesia, transiently increases IOP by around 10mmHg for ... This is significant for example if the patient requires anaesthesia for a trauma and has sustained an eye (globe) perforation. ...
In some patients who had not responded to ECT, flurothyl treatment produced improvement. The flurothyl treated patients showed ... Premedication with pentothal and succinylcholine chloride, as is customary in ECT, was tested and found safe. Four random ... The patient inhaled a mixture of vapor and air, and expired air was forced into a charcoal adsorbent via a one-way valve. ... In 1953, the Maryland pharmacologist J. C. Krantz experimented with flurothyl to induce seizures in psychiatric patients as an ...
Some patients have taken days to die, and a few patients have actually survived the process and have regained consciousness up ... Other drugs in use are tubocurarine chloride and succinylcholine chloride. Pancuronium bromide is a derivative of the alkaloid ... Cases of patients dying from hyperkalemia (usually secondary to renal failure) are well known in the medical community, where ... "Patient survives doctor-assisted suicide attempt: Terminally ill cancer victim awakes from coma after 3 days". Associated Press ...
Succinyl choline, phenothiazines and tricyclic antidepressants causes trismus as a secondary effect. Trismus can be seen as an ... Hysteric patients: Through the mechanisms of conversion, the emotional conflict are converted into a physical symptom. E.g.: ... The condition may be distressing and painful for the patient. Examination and treatments requiring access to the oral cavity ... This interference, specifically with the patient's ability to swallow properly, results in an increased risk of aspiration. In ...
History of electroconvulsive therapy in the United Kingdom
About 70 per cent of ECT patients are women. About 1,500 ECT patients a year in the UK are treated without their consent under ... The introduction in 1951 of succinylcholine, a safer synthetic alternative to curare, led to the more widespread use of ... Although the use of ECT on consenting patients fell by over a half between 1986 and 2002, its use on non-consenting patients ... Most patients in the early years of ECT were given treatment two or three times a week, or occasionally daily; a few ...
Among patients with ALS, fasciculation frequency is not associated with the duration of ALS and is independent of the degree of ... The depolarizing neuromuscular blocker succinylcholine causes fasciculations. It is a normal side effect of the drug's ... Mateen FJ, Sorenson EJ, Daube JR (2008). "Strength, physical activity, and fasciculations in patients with ALS". Amyotrophic ... "Long-term follow-up of 121 patients with benign fasciculations". Ann. Neurol. 34 (4): 622-5. doi:10.1002/ana.410340419. PMID ...
Muscle relaxants do not render patients unconscious or relieve pain. Instead, they are sometimes used after a patient is ... Succinylcholine (also known as suxamethonium in the UK, New Zealand, Australia and other countries, "Celokurin" or "celo" for ... patients. The mechanism is reported to be through upregulation of acetylcholine receptors in those patient populations with ... There are inherent risks and drug interactions that are specific to each and every patient. The agents in widespread current ...
Among patients with ALS, fasciculation frequency is not associated with the duration of ALS and is independent of the degree of ... The depolarizing neuromuscular blocker succinylcholine causes fasciculations. It is a normal side effect of the drug's ... Blexrud MD, Windebank AJ, Daube JR (1993). "Long-term follow-up of 121 patients with benign fasciculations". Ann. Neurol. 34 (4 ... Mateen FJ, Sorenson EJ, Daube JR (2008). "Strength, physical activity, and fasciculations in patients with ALS". Amyotrophic ...
Succinylcholine duration is usually on the order of 7-15 minutes and the extent of blockade is monitored with a neuromuscular ... conclude that routine measurement of dibucaine number is a cost-effective method of identifying patients at increased risk of ... When given succinylcholine, a commonly used neuromuscular-blocking drug administered for general anesthesia during surgery, the ... Pestel, G; Sprenger, H; Rothhammer, A (June 2003). "Frequency distribution of dibucaine numbers in 24,830 patients". ...
Specifically, for drug dosing the patient's length-based dosing zone can be adjusted up one color zone if the child appears ... succinylcholine), most resuscitation medications are distributed in lean body mass (e.g., epinephrine, sodium bicarbonate, ... In an emergency the time required to do this detracts from valuable time needed to evaluate, initiate, and monitor patient ... Thus incorporating a visual estimate of whether the child is over-weight provides a simple method to predict actual patient ...
... succinylcholine) and certain anesthesia. Any situations requiring the administration of anesthesia or succinylcholine (e.g., ... They recommended close individual evaluation of Rubinstein-Taybi patients for anaesthetic plans. A 2009 study found that ... and palate Anesthesia may be dangerous in these patients: "According to the medical literature, in some cases, individuals with ...
Paramedics in the United States
This may be done to allow a patient to receive a higher level of care in a more specialized facility. Registered Nurses with ... and paralytics such as succinylcholine, rocuronium, or vecuronium. Paramedics in some jurisdictions may also be permitted to ... Triage of patients in a mass casualty incident. Emergency vehicle operation. Paramedics in many jurisdictions administer a ... The same year his patient Kenneth Hahn, a member of the Los Angeles County Board of Supervisors, persuaded the Supervisors to ...
The first clinical trial of mivacurium (BW1090U), in 1984, was conducted in a cohort of 63 US patients undergoing surgical ... The same problem exists with the depolarizing NMB succinylcholine. Mivacurium is available worldwide although, in the United ... succinylcholine (suxamethonium chloride). Ironically, laudexium itself was invented by a cross-combination between the ... "The neuromuscular pharmacology of BW B1090u in anesthetized patients". Anesthesiology. 63 (3): A318. doi:10.1097/00000542- ...
... patients. The mechanism is reported to be through upregulation of acetylcholine receptors in those patient populations with ... Depolarizing muscle relaxants Succinylcholine (also known as suxamethonium in the UK, New Zealand, Australia and other ... Muscle relaxants do not render patients unconscious or relieve pain. Instead, they are sometimes used after a patient is ... Ketamine-anesthetized patients have profound analgesia but keep their eyes open and maintain many reflexes. Concerns have been ...
Rapid sequence induction
Etomidate Fentanyl Ketamine Midazolam Propofol Thiopental Succinylcholine Rocuronium Vecuronium Atropine - For patients where ... This time will be significantly reduced in obese patients, ill patients and children. Preoxygenation is usually performed by ... If the patient on initial assessment is found to have a difficult airway, RSI is contraindicated since a failed RSI attempt ... Generally the patient will be manually ventilated for a short period of time before a neuromuscular blocking agent is ...
Patient-derived isolates of Plasmodium falciparum from the Peruvian Amazon have been reported to be resistant to clindamycin as ... Clindamycin may prolong the effects of neuromuscular-blocking drugs, such as succinylcholine and vecuronium. Its similarity to ... Rarely - in less than 0.1% of patients - clindamycin therapy has been associated with anaphylaxis, blood dyscrasias, ...
Giving succinylcholine tn patients with conditions such as burns, trauma, infection, prolonged immobilisation can cause ... Trials of fludrocortisone in patients on dialysis have shown it to be ineffective. Patiromer is a selective sorbent that is ... In addition to that, high white cell count (greater than 120,000/microL) in patient with chronic lymphocytic leukemia increases ... This condition is usually suspected when patient is clinically well without any ECG changes. Mechanical trauma during blood ...
Within a few days, both the patient and her infant's symptoms were no longer present. It is assumed that if the patient ... following administration of succinylcholine injection during anesthesia were first reported in 1956. The term pharmacogenetic ... Patient genotypes are usually categorized into the following predicted phenotypes: Ultra-rapid metabolizer: patients with ... patients with reduced metabolic activity; and Poor metabolizer: patients with little to no functional metabolic activity. The ...
Adverse drug reaction
Patients have abnormal metabolism by cytochrome P450 due to either inheriting abnormal alleles or due to drug interactions. ... Inheriting abnormal butyrylcholinesterase (pseudocholinesterase) may affect metabolism of drugs such as succinylcholine ... The U.S Food and Drug Administration defines a serious adverse event as one when the patient outcome is one of the following:[7 ... In the U.S., females had a higher rate of ADEs involving opiates and narcotics than males in 2011, while male patients had a ...
... decreases the immune system's response, and although concerns about toxicity restrict its use to patients with ... activity and may result in prolonged neuromuscular blockade when administered concurrently with succinylcholine. ... August 1995). "Effects of cyclophosphamide on the development of malignancy and on long-term survival of patients with ... March 1995). "Pneumocystis carinii pneumonia: a major complication of immunosuppressive therapy in patients with Wegener's ...
Based on the information in the labeling, patients receiving metaxalone therapy and physicians prescribing metaxalone are ... Choline derivatives: Suxamethonium (Succinylcholine). *Polyalkylene derivatives: Hexamethonium. ACh release inhibitors. * ... patients receiving metaxalone therapy are directed to take metaxalone with food, and are informed that taking metaxalone with ...
Patients became desperate, as supplies of Botox were gradually consumed, forcing him to abandon patients who would have been ... Choline derivatives: Suxamethonium (Succinylcholine). *Polyalkylene derivatives: Hexamethonium. ACh release inhibitors. * ... a therapeutic course that has resulted in patient deaths. In the case of treatment of infantile esotropia in patients ... He injected the first strabismus patients in 1977, reported its clinical utility in 1980, and had soon trained hundreds of ...
5-HIAA is increased in untreated patients with malabsorption, who have increased urinary tryptophan metabolites. Such patients ... Of 75 patients with carcinoid tumors, 75% had above normal urinary 5-HIAA excretion and 64% had above normal serotonin ... Values greater than 25 mg per 24 hours (higher if the patient has malabsorption) are strong evidence for carcinoid. The normal ... Patients with renal disease may have falsely low 5-HIAA levels in the urine. ...
To encourage patients and families to share information and even offer help in explain results to extend family or refer them ... Succinylcholine is commonly used as an anaesthetic in surgical procedures, and a person with BCHE mutations may suffer ... This type of genetic testing can be used for cancer patients undergoing chemotherapy. A sample of the cancer tissue can be ... The results of testing done as part of a research study are usually not available to patients or their healthcare providers. ...
Patients became desperate, as supplies of Botox were gradually consumed, forcing him to abandon patients who would have been ... Choline derivatives: Suxamethonium (Succinylcholine). *Polyalkylene derivatives: Hexamethonium. ACh release inhibitors. * ... including spastic conditions in pediatric patients with cerebral palsy, a therapeutic course that has resulted in patient ... He injected the first strabismus patients in 1977, reported its clinical utility in 1980, and had soon trained hundreds of ...
... or secretions in the airway and poor patient cooperation. Because of this, patients with massive facial injury, complete upper ... succinylcholine, or cisatracurium besilate, before intubation of the trachea. ... In patients with elevated arterial carbon dioxide, an arterial partial pressure of CO2 (PaCO2) greater than 45 mm Hg in the ... Benumof (2007), Suresh MS, Munnur U and Wali A, Chapter 32: The patient with a full stomach, pp. 752-82 ...
Some patients have taken days to die, and a few patients have actually survived the process and have regained consciousness up ... Other drugs in use are tubocurarine chloride and succinylcholine chloride. Pancuronium bromide is a derivative of the alkaloid ... Cases of patients dying from hyperkalemia (usually secondary to renal failure) are well known in the medical community, where ... I: Studies in surgical patients". Anesthesiology. 54 (6): 468-73. doi:10.1097/00000542-198106000-00005. PMID 7235274.. ...
Patients who are prone to laryngospasm during illness can take measures to prevent irritation such as antacids to avoid acid ... In more severe cases it may require the administration of an intravenous muscle relaxant, such as Succinylcholine, and ... Laryngospasm in the operating room is treated by hyperextending the patient's neck and administering assisted ventilation with ...
Giving succinylcholine tn patients with conditions such as burns, trauma, infection, prolonged immobilisation can cause ... In addition to that, high white cell count (greater than 120,000/microL) in patient with chronic lymphocytic leukemia increases ... This condition is usually suspected when patient is clinically well without any ECG changes. Mechanical trauma during blood ... Fludrocortisone, a synthetic mineralocorticoid, can also increase potassium excretion by the kidney in patients with ...
By increasing this sleep stage, patients feel more refreshed in the morning. Improving sleep is also beneficial for patients ... Alternatively, depolarizing agents, such as succinylcholine, are nicotinic receptor agonists which mimic Ach, block muscle ... although most of these cases were reported by patients with addiction history. These effects were also reported by patients who ... It may also reduce pain in patients by inhibiting the release of substance P in the spinal cord, as well. ...
... or secretions in the airway and poor patient cooperation. Because of this, patients with massive facial injury, complete upper ... succinylcholine, or cisatracurium besilate, before intubation of the trachea. One important difference between RSI and routine ... In patients with elevated arterial carbon dioxide, an arterial partial pressure of CO2 (PaCO2) greater than 45 mm Hg in the ... The patient will be paralyzed and intubated on the ground before transport by aircraft. A cricothyrotomy is an incision made ...
The study also showed that nearly three quarters of the data on patients who took part in trials of reboxetine had not been ... Dannon PN, Iancu I, Grunhaus L (October 2002). "The efficacy of reboxetine in the treatment-refractory patients with panic ... Efficacy was clearly shown in patients with severe or very severe depression. ... patients concomitantly on MAOIs and those hypersensitive to reboxetine or any of its excipients. ...
... as do specific disease states and other patient factors. Among patient factors are: age, sex, and lean body mass. Specific ... Preliminary report of 20 patients]" (PDF). Neurocirugia (Astur) (in Spanish). 16 (1): 5-12; discussion 12-3. PMID 15756405. ... Patients with brain swelling, causing elevation of intracranial pressure, either secondary to trauma or following surgery, may ... Patients with significant swelling have improved outcomes following the induction of coma. Reportedly, thiopental has been ...
In some patients, however, and/or early in therapy, carisoprodol can have the full spectrum of sedative side effects and can ... Choline derivatives: Suxamethonium (Succinylcholine). *Polyalkylene derivatives: Hexamethonium. ACh release inhibitors. * ... Drug information for Patients, Drug information for Professionals. *. "SOMA 250 mg (carisoprodol) for Painful Musculoskeletal ... Treatment for physical withdrawal generally involves switching the patient to a long-acting benzodiazepine such as diazepam or ...
Soonawalla DF, Joshi N (May 2008). "Efficacy of thiocolchicoside in Indian patients suffering from low back pain associated ... Choline derivatives: Suxamethonium (Succinylcholine). *Polyalkylene derivatives: Hexamethonium. ACh release inhibitors. * ... "Assessment of efficacy and psychomotor performances of thiocolchicoside and tizanidine in patients with acute low back pain" ...
The results of this review article (especially the safety results) need to be confirmed by future trials on larger patient ... there has been little choice apart from succinylcholine but this drug has important contraindications; for example, it can ... Serious complications occurred in less than 1% of the patients who received sugammadex. ... populations". Sugammadex was generally well tolerated in clinical trials in surgical patients or healthy volunteers. In pooled ...
Fasciculation - Wikipedia
Among patients with ALS, fasciculation frequency is not associated with the duration of ALS and is independent of the degree of ... The depolarizing neuromuscular blocker succinylcholine causes fasciculations. It is a normal side effect of the drugs ... Blexrud MD, Windebank AJ, Daube JR (1993). "Long-term follow-up of 121 patients with benign fasciculations". Ann. Neurol. 34 (4 ... Mateen FJ, Sorenson EJ, Daube JR (2008). "Strength, physical activity, and fasciculations in patients with ALS". Amyotrophic ...
Effects of pretreatment with cisatracurium, rocuronium, and d-tubocurarine on succinylcholine-induced fasciculations and...
... and d-tubocurarine in preventing succinylcholine-induced fasciculations and postoperative myalgia in patients undergoing ... and d-tubocurarine in preventing succinylcholine-induced fasciculations and postoperative myalgia in patients undergoing ... and d-tubocurarine in preventing succinylcholine-induced fasciculations and postoperative myalgia in patients undergoing ... and d-tubocurarine in preventing succinylcholine-induced fasciculations and postoperative myalgia in patients undergoing ...
Spinal Cord Trauma - why would a patient use succinylcholine?
... succinylcholine, spinal cord trauma, surgery - Answer: Ive done some research but have not been able to find any answers. ... ... why would a patient use succinylcholine?. Asked. 18 Nov 2009 by Par64is. Active. 6 Dec 2009. Topics. succinylcholine, spinal ... Side Effects of Succinylcholine (detailed). Search for questions. Still looking for answers? Try searching for what you seek or ...
Prolonged Neuromuscular Blockade Following Succinylcholine Administration to a Patient with a Reduced Butyrylcholinesterase...
Prolonged Neuromuscular Blockade Following Succinylcholine Administration to a Patient with a Reduced Butyrylcholinesterase ... "Screening patients with prolonged neuromuscular blockade after succinylcholine and mivacurium," Anesthesia and Analgesia, vol. ... "Genotyping the butyrylcholinesterase in patients with prolonged neuromuscular block after succinylcholine," Anesthesiology, vol ... W. Kalow and D. R. Gunn, "The relation between dose of succinyl-choline and duration of apnoea in man," Journal of Pharmacology ...
In My Opinion: A Debate: Is Succinylcholine Safe for Children? - Anesthesia Patient Safety Foundation
These patients are at risk for life-threatening consequences when succinylcholine is chosen instead of a non-depolarizing drug ... 5) voice strong opposition to the label change and advocate the continued use of succinylcholine in pediatric patients. These ... For example, we routinely administer atropine when we use succinylcholine. Also, patients may be pretreated with a non- ... "No, succinylcholine should not be used routinely for elective pediatric surgery." No, succinylcholine should be used only when ...
Successful Use of Succinylcholine for Cesarean Delivery in a Patient with Postpolio Syndrome | Anesthesiology | ASA Publications
Successful Use of Succinylcholine for Cesarean Delivery in a Patient with Postpolio Syndrome. Anesthesiology 6 2008, Vol.108, ... There have been a few reports over the years using succinylcholine in patients with pathology similar to that seen in PPS. For ... We would like to comment on the recent case report on the use of succinylcholine in a patient with postpoliomyelitis syndrome ( ... We do not believe that one can conclude from this single case that succinylcholine should be used in patients with PPS. ...
Prolonged Apnea Following Succinylcholine in Cancer Patients Receiving AB-132 | Anesthesiology | ASA Publications
Prolonged Apnea Following Succinylcholine in Cancer Patients Receiving AB-132 You will receive an email whenever this article ... Prolonged Apnea Following Succinylcholine in Cancer Patients Receiving AB-132. Anesthesiology 5 1963, Vol.24, 363-367. doi: ... Richard I. H. Wang, Charles A. Ross; Prolonged Apnea Following Succinylcholine in Cancer Patients Receiving AB-132. ...
Succinylcholine Injection Drug Shortage Notice - Drugs.com
Current drugs shortage notification for Succinylcholine Injection including reason for shortage, estimated resupply dates, and ... Implications for Patient Care. * *Succinylcholine chloride injection is a depolarizing neuromuscular blocking agent and is ... During this shortage, clinicians should reserve supplies of succinylcholine for procedures where succinylcholine is the agent ... Succinylcholine Injection. Last Updated: May 26, 2016. Status: Resolved. Products Affected - Description * *Anectine injection ...
Succinylcholine Solution for injection
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Dose (based on Ideal Body Weight in obese patients) *Initial dose. *IV Dose: 1 to 1.5 mg/kg up to 150 mg IV. *Example: 120 mg ... Succinylcholine, Succinyldicholine, Suxamethonium, succinylcholine, Succinylcholine [Chemical/Ingredient], Ethanaminium, 2,2 ... Ontology: Succinylcholine. (C0038627) Definition (NCI) A quaternary ammonium compound and depolarizing agent with short-term ... 1,4-dioxo-1,4-butanediyl)bis(oxy))bis(N,N,N-trimethyl)-, suxamethonium, SUCCINYLCHOLINE, Succinylcholine (product), ...
Anesthetic management of patients with Brugada syndrome: a case series and literature review | SpringerLink
Purpose To review the anesthetic management and perioperative outcomes of patients diagnosed with Brugada syndrome (BrS) who ... and succinylcholine. In patient 8, two events were noted to occur in close relationship to initiation of a propofol infusion ... However, one patient who had received a propofol bolus and one patient who received a propofol infusion were noted to have ... In this small case series of BrS patients, the right precordial leads (V1-V3) were not monitored in any of our patients to ...
A870 SUCCINYLCHOLINE ACTIONS IN PLASMA FROM PATIENTS WITH AND WITHOUT BURNS | Anesthesiology | American Society of...
A870 SUCCINYLCHOLINE ACTIONS IN PLASMA FROM PATIENTS WITH AND WITHOUT BURNS R. J. Storella, Ph.D.; R. J. Storella, Ph.D. ... R. J. Storella, J. Hill; A870 SUCCINYLCHOLINE ACTIONS IN PLASMA FROM PATIENTS WITH AND WITHOUT BURNS. Anesthesiology 1990; 73: ... Succinylcholine Use and Dantrolene Availability for Malignant Hyperthermia Treatment: Database Analyses and Systematic Review ... Acute and Perioperative Care of the Burn-injured Patient Anesthesiology (February 2015) ...
Comparison of the intubation conditions provided by rapacuronium (ORG 9487) or succinylcholine in humans during anesthesia with...
Intubation conditions were excellent or good in 87% of patients with rapacuronium and in 95% with succinylcholine (P , 0.05). ... Intubation by 60 s after drug administration occurred in 100% of patients with rapacuronium and in 98% with succinylcholine. ... Anesthesia was induced with fentanyl and propofol and either 1.5 mg/kg rapacuronium or 1.0 mg/kg succinylcholine. The goal was ... Currently, the only approved muscle relaxant with a rapid onset and short duration of action is succinylcholine, a drug with ...
Working As A Paramedic I Have Encountered Patients Essay | Bartleby
Technical Operations Working as a paramedic I have encountered patients that required the use of my critical thinking ability, ... o Medication that was prepared • Ketamine • Succinylcholine • Rocuronium (In the event that succinylcholine was contraindicated ... Due to the severity of the trauma, the patient was closely monitored in the ICU on 3/2/15. In this reflection paper, I will ... More about Working As A Paramedic I Have Encountered Patients Essay. *. My Dream Life In College. 1580 Words , 7 Pages ...
The Efficacy and Safety of Gantacurium Chloride for Injection in Tracheal Intubation in Healthy Adult Patients Undergoing...
... succinylcholine, or placebo). ... A patient will not be eligible for inclusion in this study if ... The Efficacy and Safety of Gantacurium Chloride for Injection in Tracheal Intubation in Healthy Adult Patients Undergoing ... bolus doses of study treatments for those patients in whom the first intubation attempt at 60 seconds failed. *Blood pressure ( ... definitive information on the ultra-short acting profile of the compound by determining the quality of intubation in patients, ...
The response of a patient with Von Recklinghausen's disease to succinylcholine and atracurium | Virtual Health Sciences Library
Board Subjects: Succinylcholine ,Atracurium Citation: Mohamed I. Naguib , The response of a patient with Von Recklinghausens ... The response of a patient with Von Recklinghausens disease to succinylcholine and atracurium Naguib Mohamed I.; Middle East J ... The response of this patient to succinylcholine was normal and the response to atracurium was slightly prolonged. It is ... The response of a patient with Von Recklinghausens disease to succinylcholine and atracurium ...
Succinylcholine-assisted intubations in prehospital care
... or patient combativeness. Use of short-acting para … ... technique for airway management in critically ill patients, ... We reviewed prehospital patient intubations for two years; 215 patients were intubated by paramedics without the use of SUX and ... Succinylcholine-assisted intubations in prehospital care Ann Emerg Med. 1988 May;17(5):469-72. doi: 10.1016/s0196-0644(88)80238 ... The patient group intubated with SUX was characterized by a greater percentage of women (48% vs 35%; P less than .05), a higher ...
Analgesic Effect of Perioperative Systemic Lidocaine in Patients Undergoing Unilateral Mastectomy Surgery - Full Text View -...
Contraindication to succinylcholine. *History and/or EKG evidence of conduction defect. *Renal failure (Creatinine ,1.7 mg/dL) ... Analgesic Effect of Perioperative Systemic Lidocaine in Patients Undergoing Unilateral Mastectomy Surgery. The safety and ... In addition, patients receiving systemic lidocaine will have a lower incidence of post-mastectomy pain syndrome. ... Analgesic Effect of Perioperative Systemic Lidocaine in Patients Undergoing Unilateral Mastectomy Surgery. ...
When Not to Use Succinylcholine for Drug Assisted Intubation (also called Rapid Sequence Intubation) for Trauma Patients from...
When Not to Use Succinylcholine for Drug Assisted Intubation (also called Rapid Sequence Intubation) for Trauma Patients from ... "Because of the potential for severe hyperkalemia, succinylcholine must be used carefully in patients with severe crush injuries ... etomidate is a good choice in the trauma patients) and a paralytic (succinylcholine, vecuronium, or rocuronium) to facilitate ... "What is the utility of measuring the serum ammonia level in patients with altered mental status" - Help From The Cleveland ...
EmergencyMedJC: How to get it wrong: Succinylcholine is associated with increased mortality when used for RSI in patients with...
How to get it wrong: Succinylcholine is associated with increased mortality when used for RSI in patients with severe traumatic ... The main outcome was the difference in mortality when patients were intubated with either rocuronium or succinylcholine. ... These authors performed a retrospect data-base review of patients who were intubated in their ED for traumatic brain injury. ... They conclude, "in severely brain-injured patients undergoing RSI in the ED, succinlycholine was associated with increased ...
Comparison between succinylcholine and rocuronium as neuromuscular blocking agents for electroconvulsive therapy in a patient...
Electroconvulsive therapy was performed using succinylcholine and rocuronium as the neuromuscular blocking agents in the first ... The recovery time from muscle relaxation after succinylcholine administration was remarkably longer than that after rocuronium- ... Rocuronium and sugammadex appear to be useful in situations in which succinylcholine is contraindicated. ... We report here the anesthetic management of a patient with schizophrenia and pseudocholinesterase deficiency. ...
Current Issue : Advanced Emergency Nursing Journal
Natrecor | definition of Natrecor by Medical dictionary
Succinylcholine: potentiation of neuromuscular blockade, prolonged respiratory depression. Patient monitoring. Monitor vital ... Patient teaching. • Tell patient he may take with or without food.. • Tell patient or caregiver to shake suspension gently ... Patient teaching. • Tell patient hell be monitored closely during and for several hours after infusion.. • Inform patient that ... Patient/Family Teaching. *Explain purpose of nesiritide to patient and family.. *Advise patient to notify health care ...
Pyridostigmine bromide | definition of pyridostigmine bromide by Medical dictionary
Succinylcholine: increased and prolonged neuromuscular blockade (including respiratory depression). Patient monitoring. • ... Patient teaching. • If patient is using syrup, advise him to pour it over ice.. • Instruct patient using extended-release ... Advise patient to monitor and report his response to ongoing therapy so that optimal dosage can be determined.. • As ... Tell patient drug may cause headache and muscle cramps. Encourage him to discuss activity recommendations and pain management ...
Muscle Relaxation With Succinylcholine in Electroconvulsive... : Anesthesia & Analgesia
Six patients (1.2%) required succinylcholine doses ,2 standard deviations below the mean, or ,0.43 mg/kg. Twenty-three patients ... In this sample, patients were more likely to need and to tolerate higher doses of succinylcholine rather than lower doses for ... Some patients will need dose increases, whereas others will need far less succinylcholine than predicted. This may be because ... Most of the drugs used in ECT are highly predictable, including succinylcholine for most patients. However, providers must be ...
Propofol-Remifentanil Combination for Management of Electroconvulsive Therapy in a Patient with Neuroleptic Malignant Syndrome
And it has been suggested that the use of succinylcholine should be avoided in patients with a history of these diseases . ... 15] performed ECT on an MH susceptible patient using thiamylal without any muscle relaxant, but the patient required physical ... So patients susceptible to NMS may be vulnerable to developing MH. ECT has been used as a treatment for NMS, because it ... On examination the patient was mute and showed unusual postures characteristic of catatonia. His vital signs were as follows: ...
Free Paramedic/EMT Flashcards about Second set
Succinylcholine Dosage: Adult: IM:. 3-4mg/kg (max dose 150mg).. Succinylcholine Dosage: Pedi: IV: Adolescent and older children ... Counteracts the toxicity of a hyperkalemia patient by stabilizing the me mbranes of the cardiac cells, reducing the likelihood ... Succinylcholine Dosage: IM:. 3-4mg/kg (max dose 150mg).. Succinylcholine Special Considerations: IV administeration:. Results ... Succinylcholine Class. Neuromuscular blocker, depolarizing. Succinylcholine Action. It competes with acetylcholine receptor of ...
How are patients positioned for rapid sequence intubation (RSI)?
Zink BJ, Snyder HS, Raccio-Robak N. Lack of a hyperkalemic response in emergency department patients receiving succinylcholine ... encoded search term (How are patients positioned for rapid sequence intubation (RSI)?) and How are patients positioned for ... Place the patient in the sniffing position for adequate visualization; flex the neck and extend the head. This position helps ... Management of the difficult airway in the trauma patient. Emerg Med Clin North Am. 1998 Feb. 16(1):45-61. [Medline]. ...
Proposed Guidelines: Anesthetic Management of a SARS - Infected Patient
Intubation will preferably be performed in patients who are sedated (midazolam) and paralysed (succinylcholine or rocuronium) ... Policy for emergency tracheal intubation of SARS patients outside the OR. When patients with suspected SARS require tracheal ... Communicate with all levels of staff, involved in the patients care regarding the patients SARS status. ... Prior to patient arrival, remove from the cart what you consider necessary for the entire case and place it at least 2 meters ...
AnesthesiaRocuroniumDoseFasciculationsAdministrationIntubationRocuroniumVecuroniumHyperkalemiaAirwayEndotrachealReaction to succinylcholineDose of succinylcholineResponse to succinylcholineAcetylcholine receptorDosagePediatric patientsParalyticVentilationInjectionAtropineAnalgesiaSpasmPotassium PhosphateRespiratory depressionSeizureCurareSurgicalComplicationsDepolarizingNicotinic receptorsAtracuriumAspirationAdministrationCardiovascularUndesirableNeuromuscular junctionCirculatoryMalignant hyperthermiaOxygenMyotonicPseudocholinesteraseDesaturation in patientsAnesthetic managementVentilatory supportAdultTrauma patientsSecondary
- Study Objective: To evaluate the efficacy of cisatracurium, rocuronium, and d-tubocurarine in preventing succinylcholine-induced fasciculations and postoperative myalgia in patients undergoing ambulatory surgery. (elsevier.com)
- Measurements and Main Results: Patients were randomized to receive cisatracurium 0.01 mg/kg, rocuronium 0.06 mg/kg, d-tubocurarine 0.05 mg/kg, or saline, 3 minutes prior to intravenous (IV) succinylcholine 1.5 mg/kg. (elsevier.com)
- There was no difference among the four groups in the intubating conditions or the incidence of postoperative myalgia.Conclusion: Pretreatment with rocuronium and d-tubocurarine was superior to cisatracurium in preventing succinylcholine-induced fasciculations. (elsevier.com)
- Since asthma and ADHD are much more serious than the fasciculations themselves, this side effect may have to be tolerated by the patient after consulting a physician or pharmacist. (wikipedia.org)
- The depolarizing neuromuscular blocker succinylcholine causes fasciculations. (wikipedia.org)
- It is for this reason that the FDA Anesthetic and Life Support Drugs Advisory Committee and the Pilot Drug review team, along with the four manufacturers of succinylcholine, have recently stated that succinylcholine is contraindicated for routine use in children and adolescents except for emergency tracheal intubation or in instances where immediate securing of the airway is necessary. (apsf.org)
- Rapacuronium is an investigational nondepolarizing relaxant that also has a rapid onset and short duration and consequently should be compared with succinylcholine in its ability to facilitate rapid tracheal intubation. (nih.gov)
- Intubation conditions were evaluated in 236 patients. (nih.gov)
- Intubation by 60 s after drug administration occurred in 100% of patients with rapacuronium and in 98% with succinylcholine. (nih.gov)
- Although endotracheal intubation is considered the optimal technique for airway management in critically ill patients, performance of this task in the prehospital setting is at times difficult due to increased masseter muscle tone, vocal cord spasm, or patient combativeness. (nih.gov)
- Paramedics chose to use SUX in 69% of nonarrested patients requiring intubation. (nih.gov)
- No patient receiving SUX required emergency cricothyrotomy, nor was esophageal intubation noted in either group. (nih.gov)
- Succinylcholine-assisted intubation was used safely and selectively by the paramedics in this EMS system to permit airway control and ventilation of patients with more difficult intubations. (nih.gov)
- This Phase 2 study will provide more definitive information on the ultra-short acting profile of the compound by determining the quality of intubation in patients, at 60 seconds, as assessed by a blinded intubator. (clinicaltrials.gov)
- Drug Assisted Intubation (also called Rapid Sequence Intubation) makes use of a sedative (etomidate is a good choice in the trauma patients) and a paralytic (succinylcholine, vecuronium, or rocuronium) to facilitate emergency endotracheal intubation. (tomwademd.net)
- Succinylchoine is associated with increased mortality when used for rapid sequence intubation of severely brain injured patients in the Emergency Department. (emergencymedjc.com)
- It can also be used to help with endotracheal intubation but suxamethonium (succinylcholine) is generally preferred if this needs to be done quickly. (wikipedia.org)
- Over the next ten years, many doctors began using curare to relax their patients' muscles during abdominal surgery or during tracheal intubation (the inserting of a tube into the trachea to allow a patient to breathe). (encyclopedia.com)
- 0.2-0.6mg/kg IV, IO (over 30-60 seconds) a typical intubation dose is 20mg slow IV, consider less (e.g. 10mg) in elderly or patients with cardiac conditions. (studystack.com)
- How are patients positioned for rapid sequence intubation (RSI)? (medscape.com)
- Reynolds SF, Heffner J. Airway management of the critically ill patient: rapid-sequence intubation. (medscape.com)
- Cudnik MT, Newgard CD, Daya M, Jui J. The impact of rapid sequence intubation on trauma patient mortality in attempted prehospital intubation. (medscape.com)
- The impact of hypoxia and hyperventilation on outcome after paramedic rapid sequence intubation of severely head-injured patients. (medscape.com)
- Experts' guidelines of intubation and extubation of the ICU patient of French Society of Anaesthesia and Intensive Care Medicine (SFAR) and French-speaking Intensive Care Society (SRLF) : In collaboration with the pediatric Association of French-speaking Anaesthetists and Intensivists (ADARPEF), French-speaking Group of Intensive Care and Paediatric emergencies (GFRUP) and Intensive Care physiotherapy society (SKR). (medscape.com)
- to make tracheal intubation easier and to allow the patient to be mechanically ventilated. (artscolumbia.org)
- A 1-mg dose of vecuronium followed by 120 mg of succinylcholine was administered to induce paralysis and facilitate endotracheal intubation. (aacc.org)
- The aim of this study was to compare the first-pass intubation success rate using the (McGrath) video laryngoscope compared with conventional direct laryngoscopy in surgical patients. (bmj.com)
- Consecutive patients requiring tracheal intubation are randomly allocated to either the McGrath video laryngoscope or direct laryngoscopy using the Macintosh laryngoscope. (bmj.com)
- Although the goal is to avoid BVM ventilation after induction and paralysis, continued bagging may be necessary for patients whose blood oxygen saturation drops below 90% for any reason (eg, unsuccessful intubation, patient characteristics noted above). (medscape.com)
- Shiga T, Wajima Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. (springer.com)
- Many patients have at least one paralyzed cord, and several cases of bilateral cord paralysis have occurred postop, after intubation or upper extremity blocks. (post-polio.org)
- With this dose, good or excellent conditions for nonemergency intubation can be expected in 2 to 2.5 minutes in most patients, with maximum neuromuscular block achieved approximately 3 to 5 minutes after injection. (rxlist.com)
- Once it has been determined that the patient requires endotracheal intubation, a decision must be made as to what, if any drugs will be used to facilitate the procedure. (hawaii.edu)
- These drugs are used during tracheal intubation, during surgery of intubated patients, and to facilitate mechanical ventilation of critically ill patients. (ismp.org)
- Effect of dexmedetomidine premedication on the intraocular pressure changes after succinylcholine and intubation. (semanticscholar.org)
- We investigated whether dexmedetomidine, an alpha-2 agonist, could attenuate this increase in the IOP after succinylcholine and intubation. (semanticscholar.org)
- Sugammadex reverses neuromuscular blockade from rocuronium in approximately three minutes, faster than spontaneous recovery from succinylcholine, raising the question of whether a rocuronium plus sugammadex strategy would be appropriate to improve safety of intubation, should a "can't intubate, can't oxygenate" scenario arise . (epmonthly.com)
- Finally, the underlying pathology that caused the patient to require intubation, and the physical challenges that made it impossible to ventilate and intubate will still be present. (epmonthly.com)
- The patient requires intubation for airway protection, but succinylcholine is contraindicated due to recent stroke. (epmonthly.com)
- Rocuronium (In the event that succinylcholine was contraindicated. (bartleby.com)
- 1. Mirzakhani H, Guchelaar HJ, Welch CA,Minimum effective doses of succinylcholine and rocuronium during electroconvulsive therapy: a prospective, randomized, crossover trial. (lww.com)
- The main outcome was the difference in mortality when patients were intubated with either rocuronium or succinylcholine. (emergencymedjc.com)
- Electroconvulsive therapy was performed using succinylcholine and rocuronium as the neuromuscular blocking agents in the first seven and latter six treatments, respectively. (springeropen.com)
- The recovery time from muscle relaxation after succinylcholine administration was remarkably longer than that after rocuronium-sugammadex administration. (springeropen.com)
- Rocuronium and sugammadex appear to be useful in situations in which succinylcholine is contraindicated. (springeropen.com)
- Most received rocuronium +/-succinylcholine and reversal of neostigmine with glycopyrrolate +/- atropine. (sages.org)
- While succinylcholine has traditionally been the favorite neuromuscular blocker of emergency physicians, rocuronium is gaining in popularity. (epmonthly.com)
- In addition, many favor the prolonged intubating conditions created by rocuronium, provided the patient can be adequately ventilated while airway attempts are made. (epmonthly.com)
- It is given to reverse neuromuscular blockade from rocuronium or vecuronium in patients whose surgical case ends earlier than anticipated. (epmonthly.com)
- Similarly, in the case of a head-injured patient intubated with rocuronium, the neurosurgeon would not have to wait up to 45 minutes for rocuronium to wear off to get a detailed neurologic exam if sugammadex were used for reversal. (epmonthly.com)
- The risk of hyperkalemia has been highlighted recently with case reports of patients with unsuspected muscle disorders, primarily Duchenne's muscular dystrophy. (apsf.org)
- Another study of denervated baboons found an increase in intravascular potassium up to 5.5 mEq/l. 5 PPS is similar in pathophysiology to the baboon denervation study, and one could assume that hyperkalemia could also be seen in PPS patients. (asahq.org)
- There have been numerous reports of hyperkalemia in patients with neuromuscular disease. (asahq.org)
- The mere fact that succinylcholine was used in the current case does not preclude the possible occurrence of severe, acute hyperkalemia in subsequent cases in patients with PPS. (asahq.org)
- Because of the potential for severe hyperkalemia, succinylcholine must be used carefully in patients with severe crush injuries, major burns, and electrical injuries. (tomwademd.net)
- Succinylcholine (1.0-1.5 mg/kg IV) contraindicated in bum patients or patients with preexisting paralysis because of resultant hyperkalemia. (lsuhsc.edu)
- There has even been a report of hyperkalemia when succinylcholine was administered to a patient who had recently recovered from the disease. (renalandurologynews.com)
- When the ED physician called to inform the clinic of the patient's death, the primary care provider recalled that the patient previously had been treated with an ACE inhibitor and had developed hyperkalemia after 1 week of therapy. (ahrq.gov)
- Technical Operations Working as a paramedic I have encountered patients that required the use of my critical thinking ability, help successfully set up proper equipment for team members to successfully establish an airway, assessing, intervening and stabilizing patients, and understanding ventilator management. (bartleby.com)
- Alternative Devices o OPA o NPA o LMA o King Airway o BVM o Non-rebreather o Nasal cannula o CO2 detector for Philips monitor o End-tidal Co2 Ventilator Management Managing complex ventilator patients require critical thinking to solve problems pertaining to ventilator issues. (bartleby.com)
- Most experienced airway experts will tell you that they reach for sux when they want very rapid intubating conditions in sicker patients as compared to other neuromuscular blockers. (emergencymedjc.com)
- Selected patients with an expected normal airway are evaluated. (bmj.com)
- ENT evaluation of the upper airway in suspicious patients would be useful. (post-polio.org)
- Patients can have a respiratory failure from the airway and respiratory muscle spasm. (nih.gov)
- It is very common for a patient to experience some degree of airway obstruction when a fiberoptic scope is inserted into the mouth and the patient must breathe around it. (thehealthcareblog.com)
- Since then, all trauma patients who cannot adequately oxygenate pulmonary capillary blood or with a compromised airway or ventilation and Glasgow Coma Scale (GCS) less than 8 at the scene, undergo prehospital ETI using the RSI method. (signavitae.com)
- Patients may sometimes be unable to maintain their airway and breathe on their own. (wikidoc.org)
- In this state, patients can breathe on their own and need no help maintaining an airway. (wikidoc.org)
- Though concentration, memory, and coordination may be impaired, patients need no help breathing or maintaining an airway. (wikidoc.org)
- Once RSI is undertaken and a paralytic is administered, the patient is at considerable risk if the airway cannot be secured. (epmonthly.com)
- Several published case reports of sugammadex in a "can't intubate, can't oxygenate" scenario in the OR describe that even when neuromuscular blockade was successfully reversed as measured by train-of-four peripheral nerve monitor, the patient remained difficult to ventilate and ultimately required a surgical airway, presumably due to laryngeal edema from airway manipulation. (epmonthly.com)
Reaction to succinylcholine1
Dose of succinylcholine2
- In our practice, we have reached similar conclusions about the optimal mean dose of succinylcholine for acceptable muscle relaxation during ECT. (lww.com)
- Assuming that these data fit a standard normal distribution, we found that the mean dose of succinylcholine required was 0.96 mg/kg with a standard deviation of 0.26 mg/kg. (lww.com)
Response to succinylcholine1
- The remaining 5-10% of the succinylcholine dose acts as an acetylcholine receptor agonist at the neuromuscular junction, causing prolonged depolarization of the postsynaptic junction of the motor-end plate. (medscape.com)
- These patients were seronegative for acetylcholine receptor antibodies but demonstrated decremental responses on repetitive nerve stimulation. (ispub.com)
- An IO infusion can be used on adult or pediatric patients when traditional methods of vascular access are difficult or otherwise cause unwanted delayed management of the administration of medications. (wikipedia.org)
- Pericardial tamponade is almost always associated with significant hemodynamic compromise, especially so in pediatric patients. (ispub.com)
- older pediatric patients and adolescents: 1mg/kg IV. (oncologynurseadvisor.com)
- This course is designed for all healthcare professionals involved in the care of pediatric patients, especially those in trauma care centers. (netce.com)
- However, neuromuscular blockers have been inadvertently administered to both adult and pediatric patients who were not receiving proper ventilatory assistance. (ismp.org)
- Review of hospital records showed no difference between the groups for frequency of either aspiration pneumonia or mechanical ventilation in patients surviving to hospital admission. (nih.gov)
- 6. Patients who use ventilators often have worsening of ventilatory function postop, and some patients who did not need ventilation have had to go onto a ventilator (including long-term use) postop. (post-polio.org)
- Don't wait for ventilation to give succinylcholine. (studentdoctor.net)
- Patients with known predictors of difficult mask ventilation (Edentulous, bearded, Obstructive sleep apnea (OSA), mallampati 3 or 4) were in experimental group. (scirp.org)
- The novel submandibular technique, an important skill, increases tidal volumes during mask ventilation for certain high risk patients. (scirp.org)
- Advances in mask ventilation technique that allow it to be performed with greater success for a wider range of patients may therefore have a profound impact on morbidity and mortality. (scirp.org)
- 2 Practitioners thought they were administering a different drug, so patients may not have been supported with mechanical ventilation. (ismp.org)
- The aim of this retrospective analysis was to determine the impact of RSI on prehospital hemodynamic parameters and prehospital ventilation status on mortality rate and functional outcome in trauma patients. (signavitae.com)
- The purpose of this single center retrospective analysis was to determine a) the impact of RSI on prehospital hemodynamic parameters and b) the impact of prehospital ventilation status on mortality rate and functional outcome at discharge from hospital in trauma patients in an emergency physician-led prehospital EMS. (signavitae.com)
- Succinylcholine chloride injection is a depolarizing neuromuscular blocking agent and is typically a drug of choice for short procedures (3 minutes or less). (drugs.com)
- In this study, the efficacy and safety of gantacurium chloride for injection will also be compared to a reference drug, succinylcholine, and to placebo. (clinicaltrials.gov)
- A patient who receives an injection (shot) of this drug into a muscle quickly begins to feel dizzy and warm. (encyclopedia.com)
- Quelicin (succinylcholine chloride injection) 200 mg/10 mL vials, while not facing a shortage, are also part of the recalled products. (acc.org)
- 4 In contrast, short term use of verapamil did not worsen the decrement seen on repetitive nerve stimulation when given to patients with myasthenia gravis as a single injection or when given orally for 14 days. (ispub.com)
- Deep sedation /analgesia: "Drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. (wikidoc.org)
- Moderate sedation/analgesia or conscious sedation: "Drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. (wikidoc.org)
- 2) Is the child with masseter spasm more likely to have myoglobinuria postoperatively, and should we look for myoglobinuria in all children who receive succinylcholine? (apsf.org)
- 3-5) Patients with masseter spasm or myoglobinuria are difficult to counsel postoperatively because our information is incomplete. (apsf.org)
- Typically, a cuff is inflated in the right ankle, usually to prevent the Succinylcholine from reaching that foot so the seizure can be observed in that foot. (upmc.com)
- For example, take the case of patient who had a large MCA stroke a week prior, who comes in with status epilepticus, presumably due to the infarct acting as a seizure focus. (epmonthly.com)
- Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for. (fpnotebook.com)
- Immediate surgical intervention is required especially if the pediatric patient presents with signs of cardiac tamponade. (ispub.com)
- Such patients need immediate intervention, either in the form of pericardiocentesis or surgical decompression. (ispub.com)
- Surgical procedures on patients with Parkinson s disease (PD) are common. (medigraphic.com)
- The most dramatic complications of succinylcholine are hyperkalemic cardiac arrest and MH. (apsf.org)
- Une révision rétrospective des dossiers anesthésiques de patients porteurs d'un BrS à la Clinique Mayo a été entreprise en recherchant particulièrement les médicaments administrés, les modifications au niveau du segment ST et la survenue de complications, y compris la mort, l'instabilité hémodynamique et les dysrythmies. (springer.com)
- Les seules complications mentionnées sont la découverte d'un tracé typique du syndrome de Brugada à l'ECG, un épisode de tachycardie ventriculaire polymorphe, qui s'est spontanément transformée en rythme sinusal, et un épisode de fibrillation ventriculaire postopératoire dans le cadre d'une anesthésie péridurale. (springer.com)
- Pseudocholinesterase testing can be performed prior to surgery on those with a family history of prolonged apnea after use of succinylcholine to determine if they are at risk of complications related to this drug. (labcorp.com)
- Given the high risk of respiratory compromise and other postoperative complications, patients need to be closely monitored postoperatively. (ovid.com)
- These patients pose a greater risk for both motor and non-motor complications, mainly due to the improper management of Parkinson s medications. (medigraphic.com)
- The lack of guidelines and the complications derived from performing surgery on Parkinson s patients makes it necessary to establish a systematic approach. (medigraphic.com)
- Patients eat little, so they are at risk for bed sores and other complications). (upmc.com)
- Also, patients may be pretreated with a non-depolarizing neuromuscular blocking drug in the hope of preventing muscle fasciculations and muscle pain. (apsf.org)
- These patients are at risk for life-threatening consequences when succinylcholine is chosen instead of a non-depolarizing drug. (apsf.org)
- Because of the significant side effects associated with succinylcholine administration, anesthesiologists have been searching for a non-depolarizing muscle relaxant with rapid, reliable onset of complete, neuromuscular blockades, short duration of action, and minimal cardiovascular side effects. (apsf.org)
- Depolarizing NMBAs (ie, succinylcholine) are not reversed by these agents and their toxicity may be worsened by concomitant administration. (drugs.com)
- [ 9 ] Of these, its most clinically important substrate is the depolarizing neuromuscular blocking agent, succinylcholine, which the pseudocholinesterase enzyme hydrolyzes to succinylmonocholine and then to succinic acid. (medscape.com)
- 2. Non-depolarizing muscle relaxants cause a greater degree of block for a longer period of time in post-polio patients. (post-polio.org)
- Depolarizing agents (eg, succinylcholine) and inhaled anesthetics should be avoided because of the risk of malignant hyperthermia. (medscape.com)
- Patients with MG are somewhat resistant to depolarizing neuromuscular blockers like succinylcholine. (experts.com)
- The response of this patient to succinylcholine was normal and the response to atracurium was slightly prolonged. (who.int)
- Indeed, because laudanosine is cleared primarily via renal excretion, a cat study modelling anephric patients went so far as to corroborate that EEG changes, when observed, were evident only at plasma concentrations 8 to 10 times greater than those observed in humans during infusions of atracurium. (wikipedia.org)
- To avoid distress to the patient, TRACRIUM (atracurium besylate) should not be administered before unconsciousness has been induced. (rxlist.com)
- A total of 20 significant ST segment elevations were recorded in four patients, several of which occurred in close temporal relation to anesthetic drug administration. (springer.com)
- Prognosis for recovery following administration of succinylcholine is excellent when medical support includes close monitoring and respiratory support measures. (medscape.com)
- Patients with known pseudocholinesterase deficiency may wear a medic-alert bracelet that will notify healthcare workers of increased risk from administration of succinylcholine. (medscape.com)
- What conditions can cause delayed recovery from succinylcholine administration? (aacc.org)
- Administration can be repeated and dose can be adjusted until desired clinical effect unless patient develops symptomatic tachycardia. (aappublications.org)
- A synergistic effect may be expected with concomitant administration of succinylcholine, similar neuromuscular blocking agents, or cholinergic agonists (7.3). (nih.gov)
- Oxygen o Making sure that the oxygen tank at the head of the bed is full in the event the patient need to be transported to CT, MRI, or to assigned room on the floor. (bartleby.com)
- Preoxygenate the patient for 5 minutes with 100% oxygen by facemask or 4 tidal volume breaths of 100% oxygen if patient is conscious. (lsuhsc.edu)
- The most straightforward protocol is to deliver high-flow oxygen via a nonrebreather face mask to a spontaneously breathing patient for 3 minutes. (medscape.com)
- A nurse anesthetist provides oxygen throughout the treatment as the patient won't be breathing on their own. (upmc.com)
- The anesthetic management of patients with myotonic dystrophy (dystrophia myotonica, DM) can be challenging. (scribd.com)
- Anesthetic concerns in these patients include respiratory compromise due to muscle weakness and the avoidance of a myotonic episode. (renalandurologynews.com)
- Succinylcholine must be avoided because fasciculation can precipitate a myotonic episode. (renalandurologynews.com)
- Myotonic patients will develop muscle rigidity with succinylcholine. (mhaus.org)
- We report here the anesthetic management of a patient with schizophrenia and pseudocholinesterase deficiency. (springeropen.com)
- We present here a patient with pseudocholinesterase deficiency in whom a series of m-ECTs was performed with either SCC or ROC. (springeropen.com)
- Pseudocholinesterase deficiency is an inherited enzyme abnormality that results in abnormally slow metabolic degradation of exogenous choline ester drugs such as succinylcholine and mivacurium. (medscape.com)
- A personal or family history of an adverse drug reaction to one of the choline ester compounds, such as succinylcholine, mivacurium, or cocaine, may be the only clue suggesting pseudocholinesterase deficiency. (medscape.com)
- These patients also may notify others in their family who may be at risk for carrying one or more abnormal pseudocholinesterase gene alleles. (medscape.com)
- Pseudocholinesterase deficiency results in delayed metabolism of only a few compounds of clinical significance, including the following: succinylcholine, mivacurium, procaine, and cocaine. (medscape.com)
Desaturation in patients1
- Patient was shifted on post operative ventilatory support and was extubated the next day. (ispub.com)
- [ 8 ] The mainstay of treatment in these cases is ventilatory support until diffusion of succinylcholine from the myoneural junction permits return of neuromuscular function of skeletal muscle. (medscape.com)
- Such a patient needs good pulmonary preparation preop and a plan for postop ventilatory support. (post-polio.org)
- Identify unique anatomic or physiologic differences in children, when compared to adult patients. (netce.com)
- There is limited information regarding Off-Label Guideline-Supported Use of SandboxAlonso in adult patients. (wikidoc.org)
- There is limited information regarding Off-Label Non-Guideline-Supported Use of SandboxAlonso in adult patients. (wikidoc.org)
- Following the treatment, patients are typically monitored in the recovery room for about 30 to 45 minutes and then will either return to their hospital room or are sent home with another adult. (upmc.com)
- Lidocaine (1.0-1.5 mg/kg IV) to possibly reduce rise in intracranial pressure in head trauma patients may be considered. (lsuhsc.edu)
- As injury remains a leading cause of mortality and morbidity among children, the purpose of this course is to allow healthcare professionals to provide timely care to pediatric trauma patients and to assist parents and caregivers in recognizing measures that prevent this type of injury. (netce.com)
- Charts of 73 trauma patients, who underwent prehospital RSI over a 12-year period, were retrospectively reviewed. (signavitae.com)
- 1,2) Drugs used for RSI have known detrimental side effects, such as hypotension (3), which could worsen the outcome in trauma patients. (signavitae.com)
- Charts of trauma patients, who underwent ETI using the RSI method between January 2000 and December 2012, were retrospectively reviewed. (signavitae.com)