Neostigmine/Glycopyrrolate Administered after Recovery from Neuromuscular Block Increases Upper Airway Collapsibility by Decreasing Genioglossus Muscle Activity in Response to Negative Pharyngeal Pressure

Herbstreit, Frank; Zigrahn, Daniela; Ochterbeck, Christof; Peters, Jürgen; Eikermann, Matthias

doi:10.1097/aln.0b013e3181f70f3d

Cited by 101 publications

(69 citation statements)

References 44 publications

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“…On the other hand, the "well-meant" pre-emptive antagonism of merely suspected residual muscle relaxation is likely to do more harm than good. Cholinesterase inhibitors can impair neuromuscular transmission, threatening the integrity of the upper airway (17). In view of its pathophysiological mechanism, any residual neuromuscular blockade has implications similar to those of inadequately treated myasthenia gravis for the integrity and function of the upper airway (12, 13, 16, 36, e50).…”

Section: Figurementioning

confidence: 99%

Obstructive Sleep Apnea — a Perioperative Risk Factor

Faßbender

Herbstreit

Eikermann

et al. 2016

Deutsches Ärzteblatt International

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Section: Figurementioning

confidence: 99%

Obstructive Sleep Apnea — a Perioperative Risk Factor

Faßbender

Herbstreit

Eikermann

et al. 2016

Deutsches Ärzteblatt International

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“…(9) Bunun yanında yeterli derecede antagonize edilmezlerse postoperatif dönemde rekürarizasyona neden olup, hava yolu obstrüksiyonu, hipoventilasyon ve hipoksiye neden olabilmektedirler. (10) Bu komplikasyonlar özellikle miyastenia gravisli hastalarda daha belirgindir. Nondepolarizan kas gevşeticiler genellikle kolinesteraz enzim inhibitörleri (neostigmin, pridostigmin vb.)…”

Section: Discussionunclassified

The Use of Sugammadex in a Patient with Myasthenia Gravis

Tomak¹,

Bostan²,

Kazdal³

2011

J Turk Anaesth Int Care

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ÖZETMiyastenia gravis, postsinaptik asetilkolin reseptörlerine karşı antikor gelişimiyle karakterize otoimmün bir hastalıktır. Hastalarda nondepolarizan kas gevşeticilere karşı duyarlılık artmıştır. Sugammadeks, roküronyum ve veküronyum gibi steroid yapılı nondepolarizan kas gevşeticileri seçici şekilde bağlayarak, etkilerini kaldırmak üzere tasarlanmış yeni bir ilaçtır. Bu makalede kas gevşetici olarak 0.6 mg kg -1 roküronyum kullanılan miyastenia gravisli bir olguda, kas gücünün geri dönüşünü sağlamada 4 mg kg -1 sugammadeks kullanımı sunulmuştur.Anahtar kelimeler: Miyastenia gravis, sugammadeks, roküronyum SUMMARY The Use of Sugammadex in a Patient with Myasthenia GravisMyasthenia gravis is an autoimmune disease characterized by antibody formation against postsynaptic acetylcholine receptors. Patients demonstrate increased sensitivity to nondepolarizing muscle relaxants. Sugammadex is a new selective nondepolarizing muscle relaxant-binding agent designed to reverse the effect of steroidal muscle relaxants like rocuronium and vecuronium. This article reports the use of 4 mg kg -1 Sugammadex to reverse neuromuscular blockade in a myasthenia gravis case, where 0.6 mg kg -1 rocuronium was used as a neuromuscular blocking agent.

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“…However, we designed our study to investigate the exclusive effect of the timing of administration of the reversal agent and rule out the effect of the dose. Another reason was to determine whether blockade induced by neostigmine [19,20] occurs in this situation (and we confirm that it does not). Another limitation of this study was that the perceptions of loss of TOF or DBS-fade were subjective.…”

Section: Discussionmentioning

confidence: 99%

Timing of reversal with respect to three nerve stimulator end-points from cisatracurium-induced neuromuscular block

Song

Seo

et al. 2015

Anaesthesia

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SummaryAfter elective ear surgery with cisatracurium neuromuscular blockade, 48 adults were randomly assigned to receive neostigmine: (a) at appearance of the fourth twitch of a 'train-of-four'; (b) at loss of fade to train-of-four; or (c) at loss of fade to double-burst stimulation, all monitored using a TOF-Watch SX â on one arm. For each of these conditions, the recovery from train-of-four (TOF) ratio was measured in parallel objectively using a TOF-Watch SX placed on the contralateral arm. The median (IQR [range]) time from administration of reversal to a train-of-four ratio ≥ 0.9 was 11 (9-15.5 [2-28]) min, 8 (4-13.5 [1-25]) min and 7 (4-10 [2-15]) min in the three groups, respectively. This recovery time was significantly shorter when reversal was given at loss of fade to double-burst stimulation (c), than when given at the appearance of the fourth twitch (a), p = 0.046. However, the total time to extubation may be unaffected as it takes longer for fade to be lost after double-burst stimulation than for four twitches subjectively to appear.

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Neostigmine/Glycopyrrolate Administered after Recovery from Neuromuscular Block Increases Upper Airway Collapsibility by Decreasing Genioglossus Muscle Activity in Response to Negative Pharyngeal Pressure

Cited by 101 publications

References 44 publications

Obstructive Sleep Apnea — a Perioperative Risk Factor

Obstructive Sleep Apnea — a Perioperative Risk Factor

The Use of Sugammadex in a Patient with Myasthenia Gravis

Timing of reversal with respect to three nerve stimulator end-points from cisatracurium-induced neuromuscular block

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