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8,004 results
  • Sugammadex in Emergency Situations. [Journal Article]
    J Pers Med. 2023 Jan 15; 13(1)Motamed C
  • Sugammadex may be required or used in multiple emergency situations. Moderate and high doses of this compound can be used inside and outside the operating room setting. In this communication, recent developments in the use of sugammadex for the immediate reversal of rocuronium-induced neuromuscular blockade were assessed. In emergency surgery and other clinical situations necessitating rapid sequ…
  • A Case Report of an Incidental Ultrasound Finding in a Suspected Malignant Hyperthermia Patient. [Case Reports]
    A A Pract. 2022 Dec 01; 16(12):e01651.Fu PH, Ho CN
  • Malignant hyperthermia (MH) is a rare but life-threatening genetic disorder of the skeletal muscles triggered by inhalation anesthetics or succinylcholine. A 49-year-old female developed symptoms of MH shortly after a lumbar surgery. Despite being insidious, MH was diagnosed based on the clinical grading scale. We incidentally discovered fine fasciculations in extremities while inserting an ultra…
  • Stable Gastric Pentadecapeptide BPC 157 and Striated, Smooth, and Heart Muscle. [Review]
    Biomedicines. 2022 Dec 12; 10(12)Staresinic M, Japjec M, … Sikiric P
  • First, we review the definitively severed myotendinous junction and recovery by the cytoprotective stable gastric pentadecapeptide BPC 157 therapy, its healing that might combine both transected and detached tendon and transected muscle, ligament and bone injuries, applied alone, as native peptide therapy, effective in rat injury, given intraperitoneally or in drinking water or topically, at the …
  • Complications After Dental Sedation: A Myotonic Mystery Case Report. [Case Reports]
    Anesth Prog. 2022 12 01; 69(4):26-31.Karamlou M, Asaria I, … Hall D
  • Myotonic dystrophy (dystrophia myotonica; DM) is an uncommon progressive hereditary muscle disorder that can present with variable severity at birth, in early childhood, or most commonly as an adult. Patients with DM, especially type 1 (DM1), are extremely sensitive to the respiratory depressant effects of sedative-hypnotics, anxiolytics, and opioid agonists. This case report describes a 37-year-…
  • GeneReviews®: Calpainopathy [BOOK]
    GeneReviews®. University of Washington, Seattle: Seattle (WA)Adam MP, Mirzaa GM, … Amemiya AAngelini C, Fanin MBOOK
  • Calpainopathy is characterized by symmetric and progressive weakness of proximal limb-girdle muscles. The age at onset of muscle weakness ranges from two to 40 years. The phenotype shows intra- and interfamilial variability ranging from severe to mild. Three autosomal recessive calpainopathy phenotypes have been identified based on the distribution of muscle weakness and age at onset: Pelvifemora…
  • Trismus during tracheal extubation as a complication of general anaesthesia - A case report. [Case Reports]
    Open Med (Wars). 2022; 17(1):1712-1714.Radkowski P, Kędziora B, Dawidowska-Fidrych J
  • Tracheal extubation is a risky phase of anaesthesia. Most complications that occur when an endotracheal tube is removed are of minor nature, but those that require critical action can end in serious complications or even death. Patient - A 55-year-old woman was admitted for elective transabdominal hysterectomy and adnexal procedures. Anaesthesia - Standard monitoring. For induction, we used fenta…
  • Malignant Hyperthermia in PICU-From Diagnosis to Treatment in the Light of Up-to-Date Knowledge. [Review]
    Children (Basel). 2022 Nov 04; 9(11)Klincová M, Štěpánková D, … Štourač P
  • Malignant Hyperthermia (MH) is a rare, hereditary, life-threatening disease triggered by volatile anesthetics and succinylcholine. Rarely, MH can occur after non-pharmacological triggers too. MH was detected more often in children and young adults, which makes this topic very important for every pediatric specialist, both anesthesiologists and intensivists. MH crisis is a life-threatening severe …
  • Effect of Paralytic Agents on Post-Intubation Sedation in the Emergency Department. [Journal Article]
    Hosp Pharm. 2022 Dec; 57(6):759-766.Pankey JA, Christofferson S, … Knettel C
  • Purpose: This study aimed to evaluate the frequency at which postintubation sedation is administered following use of long-acting paralytic agents compared to short-acting paralytic agents during rapid sequence intubation performed in the emergency department. Methods: This retrospective, single-center study of intubated patients in the emergency department analyzed the difference in time to admi…
  • Acute myotonic reaction during succinylcholine anaesthesia. [Case Reports]
    Pract Neurol. 2023 Feb; 23(1):74-77.Mohammed SR, Gafoor S, Panday A
  • A 21-year-old woman developed an acute myotonic reaction while undergoing anaesthesia using succinylcholine. Examination later showed she had shoulder, neck and calf hypertrophy, bilateral symmetrical ptosis and eyelid, handgrip and percussion myotonia. Peripheral neurophysiology studies identified significant, continuous myotonic discharges in both upper and lower limbs. Genetic analysis identif…
  • StatPearls: Biochemistry, Pseudocholinesterase [BOOK]
    StatPearls. StatPearls Publishing: Treasure Island (FL)BennerAndrewAMichigan State University - College of Osteopathic MedicineLewallenNoble F.NFMichigan State University College of Osteopathic MedicineSadiqNazia M.NMBOOK
  • Pseudocholinesterase is a serine hydrolase enzyme, primarily produced in the liver that catalyzes the hydrolysis of choline esters, most prominently succinylcholine and mivacurium.[1] It is imperative to differentiate this from “true” cholinesterase, also known as acetylcholinesterase, which occurs in higher concentrations within conducting tissues such as the central/peripheral nervous systems a…
  • StatPearls: Neuromuscular Blockade [BOOK]
    StatPearls. StatPearls Publishing: Treasure Island (FL)CookDanielleDUPMC PinnacleSimonsDavid J.DJUPMC LititzBOOK
  • Neuromuscular blockade is frequently used in anesthesia to facilitate endotracheal intubation, optimize surgical conditions, and assist with mechanical ventilation in patients who have reduced lung compliance. Neuromuscular blocking agents (NMBAs) come in two forms: depolarizing neuromuscular blocking agents (e.g., succinylcholine) and nondepolarizing neuromuscular blocking agents (e.g., rocuroni…
  • Remimazolam in a Pediatric Patient With a Suspected Family History of Malignant Hyperthermia. [Case Reports]
    J Med Cases. 2022 Aug; 13(8):386-390.Petkus H, Willer BL, Tobias JD
  • Malignant hyperthermia (MH) is an acute hypermetabolic crisis, triggered in susceptible patients by the administration of succinylcholine or a volatile anesthetic agent. When providing anesthetic care for MH-susceptible patients, a total intravenous anesthetic technique with propofol or other sedative hypnotic is frequently chosen. Remimazolam is a novel benzodiazepine which, like midazolam, has …
  • Intravenous dantrolene in hypermetabolic syndromes: a survey of the U.S. Veterans Health Administration database. [Journal Article]
    BMC Anesthesiol. 2022 09 19; 22(1):298.Caroff SN, Roberts CB, … Berkowitz RM
  • CONCLUSIONS: In over 95% of cases, dantrolene administration was associated with diagnoses other than MH in critically-ill patients with hypermetabolic symptoms and medical and psychiatric comorbidities. Exploratory survey data suggested that the efficacy and safety of dantrolene in preventing mortality in hypermetabolic syndromes other than MH remain uncertain. However, randomized and controlled studies using standardized criteria between groups matched for severity are essential to guide practice in using dantrolene.
  • StatPearls: Pseudocholinesterase Deficiency [BOOK]
    StatPearls. StatPearls Publishing: Treasure Island (FL)TrujilloReinaldoRUPMC Pinnacle LititzWestWilliam P.WPUPMC LititzBOOK
  • Pseudocholinesterase deficiency, also known as butyrylcholinesterase deficiency, refers to a rare acquired or inherited defect in the pseudocholinesterase enzyme produced by the liver.[1] In clinical anesthesia practice, the muscle relaxants succinylcholine and mivacurium are drugs used to optimize intubating conditions and surgical exposure.[2] The drugs succinylcholine and mivacurium are both m…
  • The Nonirritating Concentrations of Neuromuscular Blocking Agents and Related Compounds. [Journal Article]
    J Allergy Clin Immunol Pract. 2022 Sep 13 [Online ahead of print]Gonzalez-Estrada A, Carrillo-Martin I, … Volcheck GW
  • CONCLUSIONS: Our results suggest that SPT may be performed with undiluted stock concentrations. We confirm maximal IDT NICs for cisatracurium and rocuronium. We also propose that currently recommended maximal IDT NICs of succinylcholine, neostigmine, sugammadex, and S-R-Cx could be increased, whereas the maximal IDT NIC of vecuronium could be decreased compared with current guidelines and prior reports.
  • Oxygen desaturation in a transgender man: initial concerns and recommendations regarding the practice of chest binding: a case report. [Case Reports]
    J Med Case Rep. 2022 Sep 04; 16(1):333.Kim E, Mukerji S, … Nozari A
  • CONCLUSIONS: In the clinical narrative, a healthy patient was observed to have prolonged oxygen desaturation after induction of anesthesia. Laryngospasm was suspected clinically owing to the sudden absence of end-tidal carbon dioxide. Prolonged oxygen desaturation despite appropriate interventions suggests the contribution of additional factors. We speculate that the presence of a chest binder intraoperatively predisposed the patient to more rapid oxygen desaturation less responsive to typical therapy. A chest binder would introduce mechanical restriction to the patient's breathing owing to its inherent design to compress. Although the patient was asked to remove all clothing, specific instructions were not provided regarding the removal of a chest binder. The presence of chest binding was also absent in the electronic health record, despite the documented presence of the patient's preferred gender, hormonal therapy regimen, and medical history. Ultimately, this case reflects the gap between practitioner knowledge and hospital guidelines and the practices of transgender patients. In reviewing existing literature and the potential for atelectasis with external compression, we would consider that patients refrain from chest binding for 12-24 hours before surgical procedures, resume no sooner than 24 hours after ambulation, and participate in diagnostic incentive spirometry pre- and postoperatively.
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