Residual neuromuscular block in type II diabetes mellitus after rocuronium

Armendáriz-Buil, Ignacio; Lobato-Solores, Félix; Aguilera-Celorrio, Luciano; Morros-Díaz, Emilio; Fraile-Jiménez, Enrique; Vera-Bella, Jorge

doi:10.1097/01.eja.0000435022.91954.8d

Cited by 13 publications

(10 citation statements)

References 20 publications

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“…From there, the differences found in the DURTOF70 and DURTOF90 (blocking recovery time to a TOF ratio ≥ 90 after the administration of a bolus dose of NMBA being significantly prolonged in type 2 diabetic patients compared with nondiabetics. These differences in the DURTOF90 have been observed both rocuronium [17] and vecuronium [18]. This parameter is strongly related to the risk of RNMB.…”

Section: Pharmacodynamic Parameters Of Neuromuscular Blockade In Diabmentioning

confidence: 81%

“…Both studies included only diabetic patients without clinical neuropathy, renal failure or other diseases that could interfere with the NMB. Furthermore, within these diabetic patients a worse glycemic control was not observed expressed by glycated hemoglobin, this involves a greater risk of RNMB [17]. Therefore, in type 2 diabetic patients without neuropathy, we cannot know which patients are more predisposed to RNMB.…”

Section: Risk Of Residual Neuromuscular Blockade In Diabeticsmentioning

confidence: 94%

“…However, we do know that this population has more risk of RNMB. Two papers [17,18] have reported a prolonged time to TOF ratio 0,9 (DURTOF90: variable related to the risk of RNMB) in patients with type 2 DM, one another using rocuronium (published by our Research Group) and vecuronium. Both studies included only diabetic patients without clinical neuropathy, renal failure or other diseases that could interfere with the NMB.…”

Section: Risk Of Residual Neuromuscular Blockade In Diabeticsmentioning

confidence: 99%

See 2 more Smart Citations

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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Section: Pharmacodynamic Parameters Of Neuromuscular Blockade In Diabmentioning

confidence: 81%

Section: Risk Of Residual Neuromuscular Blockade In Diabeticsmentioning

confidence: 94%

Section: Risk Of Residual Neuromuscular Blockade In Diabeticsmentioning

confidence: 99%

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Diabetes Mellitus and Neuromuscular Blockade: Review

Ignacio¹,

Felix²

2016

J Diabetes Metab

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“…Appropriate dose and vigilant monitoring of the neuromuscular blocker are recommended. 15 In another study of Yesil and colleagues it is demonstrated that phrenic nerves are affected like peripheric nerves in prediabetic and diabetic patients and reminding phrenic neuropathy in newly onset respiratory failure in diabetic and prediabetic patients without any prior existing cardiovascular or respiratory complaints is suggested. 16 That fact gives the impression that in diabetic patients without any prior existing complaints should evolve respiratory failure intra-or postoperatively due to undiagnosed phrenic neuropathy.…”

Section: Discussionmentioning

confidence: 99%

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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“…Gözlemsel prospektif bir çalışmada rokuronyum uygulamasından sonra diyabetik hastalarda diyabetik olmayan hastalara göre rezidüel nöromusküler blok riskinin artmış olduğu tespit edilmiştir [7] . Olgumuzda yaşadığımız deneyim ve ileri yaşına rağmen, yeni teşhis edilmiş diyabet ile düzensiz ilaç kullanım öyküsü altta yatan subklinik diyabetik nöropati olabileceğini düşündürmüştür.…”

Section: Olgu Sunumuunclassified

Rocuronium induced prolonged residual neuromuscular blockade in a obese and diabetic patient who had after aortocoronary artery bypass surgery

Coşkun¹,

Büyükateş²

2016

GKDA Derg

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ÖZObez olgularda kolin esteraz enzim inhibitörlerine yanıt alınamayan rezidüel nöromusküler bloğa daha sık rastlanmaktadır. Obez, diyabetik ve ileri yaş kadın hastaya yapılan aortokoroner baypas cerrahisi sonrasında ayılma ve derlenmesinde uzama olması üzerine teşhis ve tedavi edilen uzamış nöromusküler blok olgusunu sunduk.Anahtar kelimeler: aortokoroner baypas cerrahisi, roküronyum, uzamış nöromusküler blok ABSTRACT Rocuronium Induced Prolonged Residual Neuromuscular Blockade in an Obese and Diabetic Patient who Underwent Aortocoronary Artery Bypass SurgeryProlonged residual neuromuscular blockade which is unresponsive to cholinesterase inhibitors is frequently encountered in obese patients. In this case report, we present an obese and diabetic old women patient who was diagnosed and treated for an extended period of arousal and recovery time because of prolonged neuromuscular blockade after coronary artery bypass surgery.

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Residual neuromuscular block in type II diabetes mellitus after rocuronium

Cited by 13 publications

References 20 publications

Diabetes Mellitus and Neuromuscular Blockade: Review

Diabetes Mellitus and Neuromuscular Blockade: Review

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

Rocuronium induced prolonged residual neuromuscular blockade in a obese and diabetic patient who had after aortocoronary artery bypass surgery

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