Autonomic and Cardiovascular Effects of Neuromuscular Blockade Antagonism in the Dog

Clutton, R. E.; Boyd, Christie; Flora, Rostika; Payne, Judd R.; McGrath, CJ

doi:10.1111/j.1532-950x.1992.tb00015.x

Cited by 14 publications

(9 citation statements)

References 29 publications

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“…Acetylcholinesterase inhibitors have actions not only at the nicotinic but also at the muscarinic receptors [25]. The unopposed action of neostigmine, for example, would result in severe bradycardia, copious secretions, increased gastrointestinal motility and bronchospasm [10]. Consequently, a drug with antimuscarinic effects, usually atropine or glycopyrronium, must accompany acetylcholinesterase inhibitors.…”

Section: How Might Sugammadex Change the Practice Of Those Who Alreadmentioning

confidence: 99%

Clinical implications of sugammadex

Caldwell¹,

Miller

2009

Anaesthesia

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SummarySugammadex is a cyclodextrin molecule that encapsulates and inactivates rocuronium and vecuronium. As a result, any degree of neuromuscular block produced by rocuronium or vecuronium can be rapidly and completely reversed without autonomic effects. Because sugammadex is optimised for reversing rocuronium it is most likely to be used in conjunction with this drug. Sugammadex will allow deep levels of block to be maintained until the very end of surgery, and will allow block to be reversed at any time after rocuronium administration, even just a few minutes. The recommended dose-range is 2-16 mg.kg-1 (ascender), depending on the level of block. The availability of sugammadex reversal may increase the use of rocuronium, and decrease the use of suxamethonium and benzylisoquinoline neuromuscular blocking drugs. In addition, it will certainly increase pharmacy costs, which may be offset by faster recovery and discharge from the postanesthesia recovery unit. Sugammadex may also change monitoring practices in that post-tetanic count will be required to quantify deep block, and quantitative monitoring of recovery may be driven by cost concerns in order to allow the use of the smallest dose of sugammadex that gives a satisfactory train-of-four ratio. Alternatively, monitoring may essentially be abandoned since a large dose of sugammadex will reliably reverse any degree of rocuronium-induced block. The ultimate clinical utility of sugammadex will be clear only after large-scale clinical use.

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Section: How Might Sugammadex Change the Practice Of Those Who Alreadmentioning

confidence: 99%

Clinical implications of sugammadex

Caldwell¹,

Miller

2009

Anaesthesia

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“…Use of a neuromuscular blocking agent (rocuronium) provided excellent globe stability and prevented motion artefacts in the case presented here. The use of rocuronium warrants manual or mechanical ventilation of patients …”

Section: Discussionmentioning

confidence: 99%

“…The use of rocuronium warrants manual or mechanical ventilation of patients. 29,30 The eye is an ideal organ for HR-MRI because of its high tissue diversity with wide variation in water content and the need for high spatial resolution when focusing on a small region of interest. 11 The limited field of view of surface coil HR-MRI is also a downside of this modality and precludes assessment of structures adjacent to the orbit (nasal cavity, sinuses, brain) and of deeper portions of the orbit in midsize and larger dogs.…”

Section: Discussionmentioning

confidence: 99%

The localization of a conjunctivoscleral foreign body via high‐resolution microscopy coil magnetic resonance imaging in a dog

Lavaud

Lautenschläger

Voelter

et al. 2019

Veterinary Ophthalmology

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A 3‐year‐old French bulldog was presented to the ophthalmology service of the Vetsuisse Faculty, University of Zurich with a 3‐day history of conjunctival swelling of the left eye (OS). Ophthalmologic examination revealed a moderate conjunctival hyperemia and chemosis. A migrating foreign body having entered the conjunctival fornix behind the nictitating membrane was suspected. Within the first 24 hours of medical management, OS developed a panuveitis and a scleral perforation was highly suspected. Ocular and orbital ultrasound as well as conventional magnetic resonance imaging (MRI) examinations failed to confirm the presence of a perforating foreign body. A High‐Resolution MRI (HR‐MRI) using a microscopy coil was then performed with findings consistent with a perforating and migrating foreign body. A grass awn of 12 mm length was surgically retrieved “ab externo” from its’ point of entry into the sclera. To the best of our knowledge, HR‐MRI has not yet been used to examine canine eyes. This case report supports the idea that orbital imaging can be greatly enhanced with the introduction of HR‐MRI using microscopy coils with clinically relevant implications.

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“…The overall AN effect of anticholinesterase–antimuscarinic drug mixtures depends on the specific components of the mixture (Azar et al. 1983), their autonomic potency (and therefore, respective doses) (Clutton et al. 1992), speed of injection (Harper et al.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, combinations of neostigmine and glycopyrrolate (which have slow onset times and are long‐acting) caused minimal changes in humans (Mirakhur et al. 1977) and dogs (Clutton et al. 1992).…”

Section: Discussionmentioning

confidence: 99%