Control of perioperative muscle strength during ambulatory surgery

Alfille, Paul H.; Merritt, Christopher K.; Chamberlin, Nancy L.; Eikermann, Matthias

doi:10.1097/aco.0b013e328331d545

Cited by 23 publications

(17 citation statements)

References 51 publications

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“…These drugs are used by anesthesiologists to facilitate tracheal intubation [5••] and enhance surgical exposure [6]. The use of high-doses of NMBAs to achieve deep neuromuscular blockade has been shown to increase the risk of post-operative complications (Table 1) [7–19, 20•, 21, 22].…”

Section: Introductionmentioning

confidence: 99%

Residual Paralysis: Does it Influence Outcome After Ambulatory Surgery?

Farhan

Moreno-Duarte

McLean

et al. 2014

Curr Anesthesiol Rep

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Neuromuscular blocking agents are used to facilitate tracheal intubation in patients undergoing ambulatory surgery. The use of high-dose neuromuscular blocking agents to achieve muscle paralysis throughout the case carries an increased risk of residual post-operative neuromuscular blockade, which is associated with increased respiratory morbidity. Visually monitoring the train-of-four (TOF) fade is not sensitive enough to detect a TOF fade between 0.4 and 0.9. A ratio <0.9 indicates inadequate recovery. Quantitative neuromuscular transmission monitoring (e.g., acceleromyography) should be used to exclude residual neuromuscular blockade at the end of the case. Residual neuromuscular blockade needs to be reversed with neostigmine, but it’s use must be guided by TOF monitoring results since deep block cannot be reversed, and neostigmine administration after complete recovery of the TOF-ratio can induce muscle weakness. The development and use of new selectively binding reversal agents (sugammadex and calabadion) warrants reevaluation of this area of clinical practice.

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Section: Introductionmentioning

confidence: 99%

Residual Paralysis: Does it Influence Outcome After Ambulatory Surgery?

Farhan

Moreno-Duarte

McLean

et al. 2014

Curr Anesthesiol Rep

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“…Za postizanje amnezije, hipnoze, analgezije, hemodinamske stabilnosti i nepokretljivosti pacijenta tokom hirurške intervencije, danas su u upotrebi različita farmakološka sredstva 1 . Duboka anestezija obezbeđuje sve ove uslove 2,3 , ali je za postizanje adekvatne imobilnosti sa manjom dozom anestetika potrebno koristiti mišićne relaksante. Ovi lekovi blokiraju transmisiju nervnog impulsa sa nervnog na mišićno vlakno.…”

Section: Originalni Radunclassified

Examining influences of neuromuscular block post tetanic monitoring technique on the quality of surgical conditions: Neuromuscular block and quality of surgical conditions

Janković¹,

Nikolić²,

Vuković³

et al. 2016

Serb J Anes Inten Therap

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“…Future studies will also need to establish whether strategies that mitigate the perioperative consequences of OSA, including titrating narcotics and neuromuscular blocking agents carefully to minimize residual effects on upper airway muscle strength, as well as promoting early mobilization, and utilizing continous positive airway pressure, [11][12][13] decrease the occurrence of POD. If it turns out that OSA does cause POD and that there are effective strategies to prevent it from doing so, than the paper by Flink et al will be a landmark in the quest to address this most challenging perioperative complication.…”

Section: Future Directionsmentioning

confidence: 99%