scholarly journals Strokovno stališče Združenja za anesteziologijo in intenzivno medicino o uporabi sugamadeksa

2018 ◽  
Vol 87 (5-6) ◽  
Author(s):  
Neva Požar Lukanović ◽  
Dragan Dević ◽  
Rajko Kandare ◽  
Dušan Mekiš ◽  
Vesna Novak Janković ◽  
...  
Keyword(s):  
Muscle Relaxant ◽  
Muscle Relaxation ◽  
Position Statement ◽  
Muscle Relaxants ◽  
Drug Of Choice ◽  
Strength Recovery ◽  
Muscular Disease ◽  
Objective Control ◽  
Different Response ◽  
Short Time

We present our position statement for the use of sugammadex, a specific binder for aminosteroid muscle relaxants, in the most common clinical circumstances (in the case of an emergency intubation, when the patient cannot be ventilated or intubated; in patients with neuro-muscular disease, in patients with liver failure, in patients with renal failure, in patients with allergic reaction to sugammadex or to rocuronium, in cases of residual muscle relaxation and when we have to use a muscle relaxant short time after sugammadex application). Sugammadex is the drug of choice in cases of cardiac arhythmia, COPD, asthma, neuro-muscular diseases, pathological obesity, intraoperative use of continuous infusion of aminoglycoside muscle relaxants. It is therefore necessary to control the neuro-muscular block during surgery due to different response of patients to the muscle relaxant. Clinical tests alone are not an adequate substitute for objective control of muscular strength recovery.

scholarly journals Computer Controlled Muscle Relaxation: A Comparison of Four Muscle Relaxants in the Sheep

1976 ◽  
Vol 4 (1) ◽  
pp. 16-22 ◽  
Author(s):  
N. M. Cass ◽  
D. G. Lampard ◽  
W. A. Brown ◽  
J. R. Coles
Keyword(s):  
Clinical Practice ◽  
Muscle Relaxant ◽  
Muscle Relaxation ◽  
Computer Control ◽  
Muscle Relaxants ◽  
Muscle Paralysis ◽  
Precise Control ◽  
Integrated Electromyogram ◽  
Computer Controlled

Computer control of anaesthesia has been extended to include muscle relaxant drugs. Injection of d-tubocurarine, gallamine, alcuronium or pancuronium was controlled by computer to reduce the integrated electromyogram to a preset level (40 per cent of control) for one hour. A programmed level of muscle paralysis is therefore possible for use in physiological and pharmacological experiments, and in clinical practice where precise control of the degree of paralysis together with minimal dosage is advantageous.

scholarly journals A study to evaluate the skeletal muscle relaxant property of Pregabalin and Gabapentin in albino rats

2019 ◽  
Vol 8 (6) ◽  
pp. 1381 ◽  
Author(s):  
Sushma V. Naidu ◽  
Vibha Rani
Keyword(s):  
Skeletal Muscle ◽  
Muscle Relaxant ◽  
Muscle Relaxation ◽  
Statistical Significance ◽  
Muscle Relaxants ◽  
Control Group ◽  
Albino Rats ◽  
Skeletal Muscle Relaxant ◽  
Significant Difference ◽  
Group 5

Background: Skeletal muscle relaxants are the drugs which reduce unwanted spasm without interfering with consciousness and voluntary movements. The centrally acting muscle relaxants like Diazepam, is known to be GABA mimetics and other antiepileptics like Gabapentin and Pregabalin also act through the release of GABA. This study is done to investigate skeletal muscle relaxant property of these drugs in comparison to Diazepam.Methods: T Models used in the experiment are Grip Strength Test, Rota Rod Method, Beam Walk Test, Photoactometer Test. Animals were divided into 6 groups of 6 rats each: Group 1: Control group treated with normal saline (0.1 ml/10gm), Group 2: Standard-15mg/kg of Diazepam, Group 3:T1-60 mg/kg of Gabapentin, Group 4:T2-10 mg/kg of Pregabalin, Group 5:T3-60 mg/kg of Gabapentin+Diazepam, Group 6:T4- 10 mg/kg of Pregabalin+Diazepam. Mean and standard deviation was calculated for each group. One way ANOVA was used for multiple group comparisons followed by post hoc Tukey’s test for statistical significance between the groups.Results: Treatment with the above test drugs produced significant muscle relaxation and caused decreased fall off, sliding time, increase climbing time and decreased locomotor activity in all models indicating motor incoordination. The results obtained from both standard and test groups showed a highly significant difference in muscle relaxation when compared with the control group.Conclusions: The test drugs showed skeletal muscle relaxant property in rats comparable to Diazepam. In view of these results, it can open a new avenue for these drugs to be used as skeletal muscle relaxants after conducting clinical trials.

scholarly journals Sedation, Analgesia, and Muscle Relaxation During VV-ECMO Therapy in Patients With Severe Acute Respiratory Syndrome Coronavirus Type 2 (SARS-CoV-2): A Single-Center, Retrospective, Observational Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Fang Wu ◽  
Mingna Li ◽  
Zhongwei Zhang ◽  
Jiawei Shang ◽  
Yong Guo ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Observational Study ◽  
Muscle Relaxant ◽  
Muscle Relaxation ◽  
Demographic Data ◽  
Muscle Relaxants ◽  
Single Center ◽  
Optimal Dosing ◽  
Vv Ecmo

Objective: The pharmacokinetics and pharmacodynamics of ECMO-supported sedative, analgesic, and muscle relaxants have changed, but there are insufficient data to determine the optimal dosing strategies for these agents. Sedation, analgesia and muscle relaxation therapy for patients with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) receiving ECMO support are more specific and have not been fully reported. This study observed and evaluated the use of sedative and analgesic drugs and muscle relaxants in SARS-CoV-2 patients treated with VV-ECMO.Methods: This study was a single-center, retrospective and observational study. Our study includes 8 SARS-CoV-2 patients treated with VV-ECMO in an intensive care unit at Shanghai Public Health Center from February to June 2020. We collected the demographic data from these patients and the dose and course of sedation, analgesia, and muscle relaxants administered during ECMO treatment.Results: The doses of sedative, analgesic and muscle relaxant drugs used in patients with VV-ECMO were significant. Over time, the doses of drugs that were used were increased, and the course of muscle relaxant treatment was extended.Conclusion: Sedation, analgesia, and muscle relaxant use require individualized titration in patients with SARS-CoV-2 who have respiratory failure and who are receiving VV-ECMO.

scholarly journals Use of a New Syringe Pump (Springfusor®) for Muscle Relaxant Infusion

1993 ◽  
Vol 21 (4) ◽  
pp. 444-446 ◽  
Author(s):  
C. C. P. Eagle ◽  
D. F. Capes
Keyword(s):  
Muscle Relaxant ◽  
Infusion Rate ◽  
Bolus Dose ◽  
Muscle Relaxants ◽  
Syringe Pump ◽  
Background Infusion ◽  
Continuous Background ◽  
Nominal Rate ◽  
The Mean ◽  
Initial Bolus

A new spring-driven syringe pump (Springfusor 10®, Go Medical Industries, Subiaco, W.A.) was evaluated for infusion of muscle relaxants in 50 surgical cases. After an initial bolus dose, atracurium was given at a rate of 25 to 37.5 mg/hour and vecuronium at a rate of 4 to 6 mg/hour. The mean infusion rate was found to be 4% above the nominal rate of 5 ml/hour and the accuracy in all cases was within ± 20%. The Springfusor was found to be rugged, cheap and easy to use. It lacks dose flexibility but is suitable for continuous background infusion of muscle relaxants during surgery.

scholarly journals GAMBARAN LAMA KERJA ATRAKURIUM PADA PASIEN YANG MENJALANI ANESTESIA UMUM DI IBS RSUP PROF KANDOU MANADO NOVEMBER-DESEMBER 2013

e-CliniC ◽  
2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Rosiana Lamerkabel ◽  
Harold Tambajong ◽  
Diana Lalenoh
Keyword(s):  
Muscle Relaxant ◽  
Acetylcholine Receptors ◽  
Average Length ◽  
Repeated Administration ◽  
Descriptive Study ◽  
Muscle Relaxants ◽  
Inclusion Criteria ◽  
Liver And Kidney ◽  
The Subject ◽  
Keywords Muscle

Abstrak: Obat pelumpuh otot adalah obat yang digunakan selama anestesi dan memfasilitasi intubasi. Pelumpuh otot non depolarisasi merupakan antagonis dari fase I blok pelumpuh otot depolarisasi, karena ia menduduki reseptor asetilkolin sehingga depolarisasi oleh suksinilkolin sebagian dicegah. Atrakurium adalah salah satu obat pelumpuh otot non depolarisasi yang mempunyai struktur benziliquinolin yang berasal dari tanaman Leontice Leontopeltalum, keunggulan adalah metabolisme terjadi di dalam darah, tidak bergantung di pada fungsi hati dan ginjal, tidak mempunyai efek akumulasi pada pemberian berulang. Tujuan penelitian ini adalah untuk mengetahui gambaran lama kerja dari obat pelumpuh obat non depolarisasi atrakurium.Penelitian ini merupakan penelitian deskriptif prospektif yang dilakukan pada ruang pasca bedah Instalansi Bedah Sentral RSUP.Prof. DR. R. D. Kandou Manado dengan subjek berjumlah 10 orang yang telah memenuhi kriteria inklusi. Dapat disimpulkan bahwa rerata gambaran lama kerja adalah 35,6 menit. Kata kunci: pelumpuh otot non depolarisasi, atrakurium     Abstract: Muscle relaxant drugs are drugs used during anesthesia and facilitate intubation . Non- depolarizing muscle relaxants is an antagonist of the phase I block of depolarizing muscle relaxants , because it occupies the acetylcholine receptors so that depolarization by succinylcholine partially prevented . Atracurium is one of the non- depolarizing muscle relaxant drugs that have a structure that is derived from plants benziliquinolin LeonticeLeontopeltalum , excellence is metabolism occurs in the blood , does not depend on the function of the liver and kidney , had no effect on the accumulation of repeated administration . The purpose of this study is to describe the work of the old non- depolarizing paralytic drug drug atracurium . This study is a prospective descriptive study conducted on postoperative space Installation Central Surgical Hospital .Prof .DR . R. D. Kandou Manado with the subject of 10 people who have met the inclusion criteria . It can be concluded that the average length of employment was 35.6 overview minutes. Keywords: Muscle relaxants, Atracurium

THE RATE OF RESIDUAL NEUROMUSCULAR BLOCKADE AFTER LAPAROSCOPIC APPENDECTOMY SURGERY AT NGUYEN TRI PHUONG HOSPITAL

2021 ◽  
Vol 62 (6) ◽  
Author(s):  
Doan Minh Nhut ◽  
Nguyen Van Chinh
Keyword(s):  
Neuromuscular Blockade ◽  
Laparoscopic Appendectomy ◽  
Muscle Relaxant ◽  
Muscle Relaxation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Residual Rate ◽  
Residual Neuromuscular Blockade ◽  
Study Results

Introduction: In Vietnam, using a muscle accelerator to measure the TOF index to monitor residue neuromuscular blockade has not been performed routinely, extubation is mainly based on subjective clinical assessments. Methods: A cross-sectional study on 96 patients undergoing laparoscopic appendectomy at Nguyen Tri Phuong Hospital, from November 2020 to May 2021. Objectives: The study was conducted with 2 objectives including (1) Determine the progression of TOF index at 7 time points: immediately after arriving in the recovery room, after extubation, 15 minutes, 30 minutes, 60 minutes, 90 minutes, 120 minutes after extubation; (2) Determination of residual muscle relaxant rate of patients undergoing laparoscopic appendectomy at Nguyen Tri Phuong Hospital. Results: The average TOF ≥ 0,9 index after laparoscopic appendectomy at the time of resuscitation was 88.11%, extubation was 90.53% and at 120 minutes after extubation. is 99.88%. Residual muscle relaxation after surgery when TOF index < 0.9. At the time of resuscitation, the highest residual rate of muscle relaxant accounted for 58.33%, followed by the time of extubation 39.58%, 15 minutes after extubation was 21.88%. Until 120 after extubation, there is no case that has residue neuromuscular blockade. Conclusion: Through the study results, it is necessary to monitor patients undergoing laparoscopic appendectomy with quantitative devices to more accurately assess the clinical index of muscle relaxation.

Modulation of vascular tone by neutrophils: dependence on endothelial integrity

1989 ◽  
Vol 257 (4) ◽  
pp. H1315-H1320
Author(s):  
J. L. Mehta ◽  
D. L. Lawson ◽  
W. W. Nichols ◽  
P. Mehta
Keyword(s):  
Smooth Muscle ◽  
Vascular Smooth Muscle ◽  
Muscle Relaxant ◽  
Muscle Tone ◽  
Muscle Relaxation ◽  
Smooth Muscle Relaxation ◽  
Smooth Muscle Tone ◽  
High Concentrations ◽  
Vascular Smooth Muscle Tone ◽  
Smooth Muscle Relaxant

To determine the influence of polymorphonuclear leukocytes (PMNLs) on vascular smooth muscle tone, isolated human PMNLs (10(4)–10(7) cells/ml) were suspended in a tissue bath with precontracted rat aortic rings with or without endothelium. PMNLs in low concentrations (10(4) and 10(5) cells/ml) caused a mild contraction, and in higher concentrations (10(6) and 10(7) cells/ml) caused a modest relaxation of aortic rings with intact endothelium. In contrast, PMNLs caused a potent concentration-dependent relaxation of deendothelialized rings (P less than 0.01 compared with rings with intact endothelium). The PMNL-induced vascular smooth muscle relaxation was abolished by both hemoglobin and methylene blue and potentiated by both superoxide dismutase and captopril. Although suspension of PMNLs caused release of eicosanoids, thromboxane A2 and prostacyclin, from rings with intact endothelium, neither indomethacin nor the TxA2-endoperoxide receptor antagonist SQ 29548 modified the effects of PMNLs on vascular smooth muscle tone. These observations suggest that unstimulated PMNLs generate a smooth muscle relaxant, which has biological characteristics similar to the endothelium-derived relaxing factor. Since the activity of this PMNL-derived smooth muscle relaxant is more pronounced in deendothelialized vascular segments, it appears that endothelium provides a barrier against vasorelaxation by high concentrations of PMNLs.

scholarly journals Hospitalization and Combined Use of Opioids, Benzodiazepines, and Muscle Relaxants in the United States

2019 ◽  
Vol 55 (5) ◽  
pp. 286-291
Author(s):  
Jonathan H. Watanabe ◽  
Jincheng Yang
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Longitudinal Analysis ◽  
Muscle Relaxant ◽  
The United States ◽  
Muscle Relaxants ◽  
Medical Expenditure ◽  
Benzodiazepine Use ◽  
Opioid Users ◽  
Triple Threat

Introduction: Concurrent opioid and benzodiazepine use (“double-threat”) and double-threat and muscle relaxant use (“triple-threat”) are postulated to increase morbidity versus opioids alone. Study objectives were to measure association between double- and triple-threat exposure and hospitalizations in a validated, nationally representative database of the United States. Methods: A retrospective cohort study was conducted using the 2013 and 2014 Medical Expenditure Panel Survey (MEPS) longitudinal dataset and affiliated Prescribed Medicines Files. Association between 2013 and 2014 double- and triple-threat exposures and outcome of hospitalizations compared to nonusers, opioid users, and all combinations were assessed via logistic regression. The cohort surveyed in MEPS has been weighted to be reflective of the actual US population in the years 2013 and 2014. Logistic regression applying the subject-level MEPS survey weights was performed to measure association via odds ratios (ORs) of medication exposures with the outcome of all-cause hospitalization. Study subjects were categorized into exposure groups as nonusers (nonuse of opioids, benzodiazepines, or muscle relaxants), opioid users, benzodiazepine users, muscle relaxant users, “double-threat” users, and “triple-threat” users. Analyses were conducted using RStudio® 1.1.5 (Boston, MA) with α level = 0.05 for all comparisons. Results: Opioids, benzodiazepines, and muscle relaxants were used in 11.9% (38.4 million), 4.2% (13.5 million), and 3.4% (10.9 million) lives of the United States in 2013, respectively. Double-threat prevalence rose from 1.6% to 1.9% from 2013 to 2014. Triple-threat prevalence remained unchanged at 0.53%. Compared to nonusers, triple-threat patients increased hospitalization probability with ORs of 8.52 (95% confidence interval [CI]: 8.50-8.55) in 2013, 5.06 (95% CI: 5.04-5.08) in 2014, and 4.61 (95% CI: 4.59-4.63) in the 2013-2014 longitudinal analysis. Compared to nonusers, double-threat patients increased hospitalization probability with ORs of 5.71 (95% CI: 5.69-5.72) in 2013, 11.47 (95% CI: 11.44-11.49) in 2014, and 5.59 (95% CI: 5.57-5.60) in the longitudinal analysis. Conclusion: Concurrent opioid and benzodiazepine use and opioid, benzodiazepine, and muscle relaxant use were associated with increased hospitalization likelihood. Amplified efforts in surveillance, prescribing, monitoring, and deprescribing for concurrent opioid, benzodiazepine, and muscle relaxant use are needed to reduce this public health concern.

Comparison of atracurium and vecuronium as muscle relaxants for ocular and orthopaedic interventions in dogs

2019 ◽  
Author(s):  
Rohit Kumar ◽  
Adarsh Kumar ◽  
Amit Kumar ◽  
S. P. Tyagi
Keyword(s):  
Positive Pressure Ventilation ◽  
Muscle Relaxation ◽  
Muscle Relaxants ◽  
Positive Pressure ◽  
Central Position ◽  
Normal Range

Twenty adult dogs of either sex, divided into 2 equal groups were used for evaluation of atracurium (0.5 mg/kg IV) and vecuronium (0.1 mg/kg IV) in atropine-butorphanol-diazepam premedicated and propofol (till effect IV) induced dogs which were further maintained on isoflurane with controlled IPPV mode of the ventilator for positive pressure ventilation. A total of 13 ophthalmic and 7 orthopaedic interventions were done in both the groups. Pulmonary parameters were measured at baseline (pre-operative), just after induction and at 5, 15, 30 and 45 minutes after the administration of NMBA and the recovery parameters were recorded after weaning from the anaesthetic gas. The eyeballs deviated to the ventro-medial position after the induction with diazepam and propofol and resumed the central position within 30 seconds of atracurium or vecuronium administration thus, proving highly beneficial for the eye globe and corneal interventions. On a comparative basis, atracurium and vecuronium provided muscle relaxation for 40.1 ± 4.71 and 37.7 ± 1.01 minutes respectively. Uniform and pronounced muscle relaxation along with excellent sedation was found in both the groups. All pulmonary parameters remained within normal range. Following discontinuation of the isoflurane, the time taken to bear weight was 38.88 ± 1.45 and 39.63 ± 4.08 minutes in the atracurium and vecuronium groups respectively.

scholarly journals Penerapan Terapi Relaksasi Otot Progresif Untuk Menurunkan Hipertensi Di Desa Glandang Bantarbolang

2021 ◽  
Vol 1 ◽  
pp. 1501-1508
Author(s):  
Hema Agustian ◽  
Wiwiek Natalya ◽  
I Isytiaroh
Keyword(s):  
Blood Pressure ◽  
Muscle Relaxant ◽  
Muscle Relaxation ◽  
Progressive Muscle Relaxation ◽  
Lower Blood Pressure ◽  
Relaxation Therapy ◽  
Hypertensive Patients ◽  
Lower Blood ◽  
Health Field ◽  
Descriptive Method

AbstractHypertension is the increase of blood pressure which is higher than or equal to 140 mmHg at systolic blood pressure and higher or equal to 90 mmHg at diastolic blood pressure. The purpose of this study is to implement actions of progressive muscle relaxant therapy to lower blood pressure on hypertensive patients. This research uses descriptive method and tye subjects of this research are two hypertension clients with blood pressure higher than 140/100 mmHg at Glandang Village, Bantarbolang. Intervention is done by giving progressive muscle relaxation therapy for six days and is done once a day. The result of the study shows a drop in blood pressure on both clients, for client 1 to drop blood pressure from 160/100mmhg to 130/90mmhg and for the second client to drop in blood pressure from 170/100mmhg to 130/100mmhg. The study of the case indicates that progressive muscle relaxation therapy reduces blood pressure on hypertensive people. It is recommended for nurses or people working in health field to provide therapy in order to lower blood pressure in the form of progressive muscle relaxation therapy in hypertensive people.Keywords: Progressive Muscle Relaxation, Hypertension AbstrakHipertensi merupakan penyakit the silent killer yang menyebabkan 1 dari 3 orang dewasa terkena penyakit hipertensi dan diperkirakan 7,5 juta kematian didunia ini akibat hipertensi. Pada umumnya penyakit hipertensi ini tidak disadari oleh penderitanya, 50% penderita hipertensi tidak memperlihatkan pertanda yang pasti, terutama apabila sedang dalam taraf awal. Tujuan studi kasus ini adalah untuk mengaplikasikan tindakan terapi relaksasi otot progresif untuk menurunkan tekanan darah pada penderita hipertensi. Rancangan Karya Tulis Ilmiah ini menggunakan metode studi kasus deskriptif dengan subyek dua klien hipertensi yang mengalami tekanan darah tinggi diatas 140/100mmHg di Desa Glandang Bantarbolang. Intervensi yang dilakukan adalah pemberian terapi relaksasi otot progresif selama enam hari dan dilakukan satu kali sehari. Hasil studi ini menunjukan adanya penurunan tekanan darah pada kedua klien, untuk klien 1 mengalami penurunan tekanan darah dari 160/100mmHg menjadi 130/90mmHg dan untuk klien kedua mengalami penurunan tekanan darah dari 170/100mmHg menjadi 130/90mmHg jadi rata-rata penurunan tekanan darah dari kedua klien adalah untuk tekanan darah sistolik sebanyak 30-40mmHg dan untuk tekanan diastolik sebanyak 10mmHg. Simpulan studi kasus ini menunjukan bahwa terapi relaksasi otot progresif mampu menurunkan tekanan darah pada penderita hipertensi. Saran bagi tenaga kesehatan diharapkan dapat memberikaan tindakan terapi untuk menurunkan tekanan darah yang berupa terapi relaksasi otot progresif pada penderita hipertensi.Kata kunci: Relaksasi Otot Progresif, Hipertensi

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