Residual neuromuscular blockade in the postoperative period contributes to significant morbidity and possibly mortality. The incidence of residual neuromuscular blockade has been shown to decrease with the use of neuromuscular monitoring and short acting neuromuscular blocking drugs. Because of marked variation in patient's sensitivity to neuromuscular blockade, the neuromuscular function of th...

Prolonged neuromuscular blockade from succinylcholine after neostigmine administration has been reported in patients with frank renal failure. We present a case of prolonged neuromuscular blockade from succinylcholine administration, given 2 hours after neostigmine reversal of neuromuscular blockade in a patient with chronic renal insufficiency. This case shows that patients with chronic renal ...

PURPOSE To review recent findings concerning neuromuscular blockade and monitoring at the larynx, the diaphragm, and the corrugator supercilii muscle. SOURCE This narrative review is based on recent publications. PRINCIPAL FINDINGS Neuromuscular blockade at the larynx and the diaphragm is less intense than at the adductor pollicis muscle; the onset and offset of neuromuscular blockade is mo...

background: food-born botulism is caused by ingestion of contaminated food with clostridium botulinum neurotoxin. case: in food-born botulism, due to acetylcholine release blockade, neuromuscular signs and symptoms are common, but in this case report we present a food-born botulism with papiledema and venous sinus thrombosis. conclusion: papiledema and fever could not rule out the diagnosis of ...

Objectives At the completion of this course, the reader should be able to: 1. Identify the anatomy and physiology of acetylcholine and nicotinic acetylcholine receptors. 2. Describe the method of action of neuromuscular blocking drugs. 3. Describe the available methods for monitoring recovery from neuromuscular blockade. 4. Discuss the options available to reverse neuromuscular blockade and the...

This review outlines the basic pharmacodynamic and pharmacokinetic properties of sugammadex for the cardiac anesthesiologist. It describes the different clinical scenarios when sugammadex can be used during cardiac surgery and gives clinical recommendations. Sugammadex is a unique reversal drug that binds a chemical complex with rocuronium and vecuronium, by which the neuromuscular blockade is ...

Sharrard, Zachary, Lorber and Bruce (1963) in a study offorty children with spina bifida cystica, eighteen of whom survived three months, concluded that “operative closure of myelomeningocele should be regarded as a surgical emergency”. They believed that it was ethically unjustifiable to continue their controlled trial of treatment. Following this paper there was a wide acceptance of early clo...

The plasma concentrations of pyridostigmine were measured in eight patients during the antagonism of non-depolarizing neuromuscular blockade. After the injection i.v. of pyridostigmine bromide 14.6 mg/70 kg, the concentration of the drug rapidly decreased between 2 and 7 min, and then declined more slowly. After 2 h, significant amounts of pyridostigmine were still present in the plasma of all ...

neostigmine), reverses neuromuscular blockade rapidly and effectively by encapsulating free circulating steroidal neuromuscular blocking agents (e.g., rocuronium) directly [1]. Moreover, sugammadex does not have muscarinic properties, whereas neostigmine has significant adverse muscarinic effects. Therefore, sugammadex is used in many countries as a new neuromuscular reversal agent to antagoniz...