Neuromuscular disorders (NMDs) are a heterogeneous group of neurological and muscular diseases. Patients present with typical features such as wasting and weakness of skeletal muscles. However, despite these common clinical signs, underlying etiologies are nearly as multifaceted as the number of the diseases. For the anesthesiologist, it is very important to know the origin of a particular dise...

We read with appreciation and concern the review article by Isenstein et al,’ which appeared in the October 1992 issue of Chest. The authors have provided clinically relevant information that is familiar to most anesthesiologists, but it may not be the case for other specialists. With more newly available drugs and better monitoring techniques, there is a current trend toward increasing usage o...

Histamine release by neuromuscular blocking agents Sir,—The design of the study by Naguib and colleagues [1] on the histamine releasing potencies of various neuromuscular blocking drugs resulted in cardiovascular changes which were profound, adverse and predictable. For example, the data sheet for mivacurium suggests administration over 5–15 s. The authors chose 5 s, despite quoting references ...

[This corrects the article on p. 500 in vol. 70, PMID: 29046769.].

Myasthenia gravis is a neuromuscular disease with multisystemic involvement and multiple drug interactions not restricted to blockers, but also including anaesthetic analgesic agents, increasing the risk of anaesthesia-related complications. In this case report, we describe our safe effective technique for Gravis patient submitted Video-Assisted Thoracoscopy thymectomy, requiring block. Since a...

Introduction. Maintenance dosing of neuromuscular blocking agents is complex and varies with patient, procedure, and clinical situation. With this in mind, we sought to identify factors impacting the maintenance dosing of neuromuscular blockers as a step toward identifying best practice with respect to minimizing residual neuromuscular blockade. Methods. Cases utilizing rocuronium from July 1, ...

Neostigmine failed to modify the development of neuromuscular block in the presence of a high local concentration of tubocurarine. Only when the concentration of tubocurarine was reduced, and a suitable concentration gradient established between the receptor area and the plasma, did neostigmine increase the rate of recovery from the action of non-depolarizing neuromuscular blocking agents.

This systematic review describes the evidence on the use of acceleromyography for perioperative neuromuscular monitoring in clinical practice and research. The review documents that although acceleromyography is widely used in research, it cannot be used interchangeably with mechanomyography and electromyography for construction of dose-response curves or for recording different pharmacodynamic...

We have investigated the effects of adenosine i.v. on neuromuscular block induced by rocuronium, vecuronium and pipecuronium in an in vivo guinea-pig sciatic nerve-tibialis anterior preparation. The ED50 of each neuromuscular blocker was determined from cumulative log dose-response regression lines (n = 14). In separate experiments, adenosine 0.1 mg kg-1 min-1 or the same volume of 0.9% NaCl wa...