<i>Retracted</i>: Reversal of vecuronium with neostigmine in patients with diabetes mellitus

Saitoh, Yuhji; Hattori, Hiroyuki; Sanbe, Norie; Nakajima, Hiroshi; Akatu, Masahiko; Murakawa, Masahiro

doi:10.1111/j.1365-2044.2004.03833.x

Cited by 14 publications

(11 citation statements)

References 33 publications

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“…4,5,8 This fact can explain the delayed return of the neuromuscular function in aforementioned studies of Saitoh and colleagues. However, sugammadex effects by incapsulation of rocuronium molecules without any impact on the neuromuscular junction, thus we think that is the reason of why no difference occurred in terms of reversal times from neuromuscular blockade between diabetic and nondiabetic patients.…”

Section: Discussionmentioning

confidence: 90%

“…13 In other studies of the same author, the TOF ratio was lower at 3 min, 6 min, 9 min, 12 min and 15 min after administration of the reversal agent neostigmine in the diabetic group than in the control group, however the differences did not reach statistical significance. 8 The recovery of T1/control and TOF ratio were delayed in diabetic patients receiving anticholinesterase. 9 Times to return of T2, T3, T4 and a TOF ratio of 0.9 were significant longer in diabetic patients.…”

Section: Discussionmentioning

confidence: 97%

“…In two of aforementioned studies Saitoh and colleagues concluded that the recovery parameters obtained through neuromuscular monitorisation were delayed in diabetic patients receiving anticholinesterase and concurrently parameters of return of neuromuscular function in diabetics were significantly longer than in the control groups. 8,9 We planned our study in light of the prior with the hypothesis, that times to reversal and recovery from neuromuscular blockade which is reversed with sugammadex will not differ significantly in diabetic and nondiabetic patients due to its unique mechanism of action.…”

Section: Reversal Effects Of Sugammadex In Diabetic Patients Having Nmentioning

confidence: 99%

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Reversal Effects of Sugammadex in Diabetic Patients Having Neuromuscular Block with Rocuronium

Ersoy¹,

Demiraran²,

Sezen³

et al. 2015

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : In our study we aimed to compare the time of antagonism and effect of sugammadex which is used for antagonism of rocuronium on diabetic and nondiabetic patients. Sugammadex is a new generation antagonist of neuromuscular blockade which effects by encapsulating rocuronium molecules in the neuromuscular junction through acting like a synthetic receptor of rocuronium. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Included patients were divided into two groups: diabetic (n=21) and non-diabetic (n=20). After loss of eyelid reflex and automatically identification of supramaximal stimulating current by the neuromuscular monitoring system, rocuronium 0.6 mg/kg IV was administered. Train-of-four (TOF) stimulation with the supramaximal current was applied and by recording of second TOF value the patient was intubated. TOF stimulation was performed and recorded every 20 seconds. Intraoperatively by return of T2, rocuronium 0.15 mg/kg IV was administered. T2i time was recorded as intubation time whereas T2d time was recorded as clinical effect time. At the end of the operation sugammadex 2 mg/kg IV was administered. When TOF ratio reached 0.9, patients were extubated and the time interval was recorded. R Re es su ul lt ts s: : There was no differences between two groups of intubation time ( 19±239,21 [228 (20-945)] seconds in diabetics and 228, 20±115,22 [238.5 (54-446)] seconds in non-diabetics (p=0.611). There were no statistical significant difference between the two groups in intubation time, clinical effect time, extubation time and recovery time. C Co on nc cl lu us si io on n: : Contrary to expected delay of clinical effect and recovery times with conventional reversal agents in diabetic patients resulting from diabetic complications has not occurred with sugammadex. In conclusion, sugammadex seems to be like a good alternative for diabetic patients because of its role in reversing the effects of neuromuscular blocking agents as well as alleviating problems in recovery period.K Ke ey y W Wo or rd ds s: : Diabetes mellitus; neuromuscular blockade; sugammadex Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada, rokuronyumun antagonizması için kullanılan sugammadeksin antagonizma ve etki sü-relerinin diyabetik ve diyabetik olmayan hastalarda karşılaştırılması amaçlanmıştır. Sugammadeks, etkisini nöro-musküler kavşaktaki rokuronyum moleküllerini enkapsüle ederek gösteren, rokuronyum için sentetik bir reseptör gibi davranan yeni nesil nöromusküler blok antagonistidir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Hastalar diyabetik (n=21) ve diyabetik olmayan (n=20) olmak üzere iki gruba ayrıldı. Kirpik refleksi kaybından sonra supramaksimal uyarı nöro-musküler monitörizasyon sistemi tarafından otomatik olarak belirlendi ve rokuronyum 0,6 mg/kg intravenöz olarak uygulandı. Supramaksimal uyarı ile "train-of-four (TOF)" stimülasyonu yapıldı ve TOF2 değeri elde edilince hasta entübe edildi. Yirmi saniyede bir TOF stimülasyonu yapılarak, değerler kaydedildi...

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Section: Reversal Effects Of Sugammadex In Diabetic Patients Having Nmentioning

confidence: 99%

See 1 more Smart Citation

Reversal Effects of Sugammadex in Diabetic Patients Having Neuromuscular Block with Rocuronium

Ersoy¹,

Demiraran²,

Sezen³

et al. 2015

Turkiye Klinikleri J Med Sci

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“…Some researchers demonstrated that recovery from the nondepolarizing neuromuscular agent, vecuronium, is delayed in diabetic patients compared with nondiabetic patients [26][27][28] because diabetic patients exhibit degeneration, demyelination, or axon loss in the motor nerve ending of the neuromuscular junction and infarction or atrophy in the skeletal muscle. It is known that volatile anesthetics such as sevoflurane or isoflurane enhance the action of neuromuscular relaxants, so that physicians must be aware of delayed recovery from the effects of nondepolarizing neuromuscular-blocking agents under volatile anesthetics in diabetic patients.…”

Section: Neuromuscular Agentsmentioning

confidence: 98%

Anesthetic considerations in diabetic patients. Part II: intraoperative and postoperative management of patients with diabetes mellitus

Kikuchi

2010

J Anesth

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Some studies have reported that tight glycemic control in diabetic patients undergoing major surgery improves perioperative morbidity and mortality rates. Recently, however, large randomized studies have shown such control increases the mortality rate, since aggressive glycemic control induces more frequent incidences of hypoglycemia. Diabetic patients have cerebral complications during the perioperative period more often than their nondiabetic counterparts. Further, anesthetic agents have some effects on cerebral circulation and cerebrovascular carbon dioxide reactivity. Hence, anesthesiologists should have adequate knowledge about anesthetic agents that maintain the integrity of the cerebral circulation. Patients with diabetes mellitus (DM) have an increased susceptibility to perioperative infections. Recent work confirmed that a combination of intravenous and subcutaneous insulin as a glucose management strategy had beneficial effects identical with intravenous insulin therapy alone on the reduction of infection rates during the postoperative period.

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“…studied. Saitoh [25] in 2004, noted that the number of diabetic patients with TOF ratio < 0.9 was significantly greater than non-diabetics 15 minutes after neostigmine administration. Considering the pathophysiological changes described above, if less Ach is released, the reversion provided with anticholinesterase drugs will be slower because it is a competition between the concentration of NMB and Ach.…”

Section: Nmb Monitoring In Diabetic Patientsmentioning

confidence: 99%

Diabetes Mellitus and Neuromuscular Blockade: Review

Ignacio¹,

Felix²

2016

J Diabetes Metab

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Introduction and objectives: International Diabetes Federation (IDF) estimates that worldwide there are 415 million adults aged 20-79 with diabetes mellitus (DM). Although diabetes mellitus (DM) is a highly prevalent disease, only a handful of studies have examined the neuromuscular function in diabetic patients. Even more surprising is this data, if we think that neuromuscular blockade (NMB) is an essential part in the induction and maintenance of general anesthesia. NMB is induced by neuromuscular blocking agents (NMBA). The aim of this review is to update the knowledge of neuromuscular blockade in diabetes mellitus and its implications in clinical practice.

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Retracted: Reversal of vecuronium with neostigmine in patients with diabetes mellitus

Cited by 14 publications

References 33 publications

Reversal Effects of Sugammadex in Diabetic Patients Having Neuromuscular Block with Rocuronium

Reversal Effects of Sugammadex in Diabetic Patients Having Neuromuscular Block with Rocuronium

Anesthetic considerations in diabetic patients. Part II: intraoperative and postoperative management of patients with diabetes mellitus

Diabetes Mellitus and Neuromuscular Blockade: Review

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