No abstract available.
Neuromuscular Blockade*

No abstract available.
Intubation ; Neuromuscular Blockade ; Neuromuscular Blocking Agents

This paper presents an echo of what transpired during the meeting written in a question ans answer format.
MUSCLE RELAXANTS, CENTRAL ; NEUROMUSCULAR BLOCKADE ; NEUROMUSCULAR AGENTS

No abstract available.
Humans ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents*

In this study, we have assessed correlation between maximum inspiratory pressure(MIP) and train of four(TOF) ratio. During neuroleptanesthesia, vecuronium was administered intravenously to 45 patients under TOF monitoring. MIP and TOF ratio was measured every 5 minutes at recovery from neuromuscular blockade. The results were as follows: 1) During neuromuscular recovery, good correlation existed between MIP and TOF ratio. 2) When TOF ratio was 0.65+/-0.05, MIP was 30.4I+/-4.47cmH,O. 3) When TOF ratio was 0.85+/-0.05, MIP was 52.18+/-4.34 cmH,O. These results were suggested that TOF ratio of above 0.8 was consistent with ability to protect the patient's airway against aspiration and obstruction.
Humans ; Neuromuscular Blockade ; Vecuronium Bromide*

The hypothesis that administration of neostigmine in divided doses might accelerate the antagonism of nuromuscular blockade was investigated. Neostigmine 0.05mg/kg was adminsitered either in a single bolus dose (Group I, n=10) or in an initial dose of 0.01 mg/kg 1 minute later (Group II, n=10), 2 minutes later (Group III, n=10) and 3 minutes later (Group IV, n=10) for antagonism of vecuronium- induced blockade. Reversal was attepted at 10 percent spontaneous recovery of twitch height. The mean time (+/-SE) from the first injection of the drug until the train-of-four(TOF) ratio value had reached 0. 75 was signifincantly longer in Group II and IV (594.8+/-63.9 seconds and 555.6+/-22.2 seconds respectively) than Group I and III (380.6+36.0 seconds and 357.8+/-44.2 seconds respectively). It is concluded that adminstration of neostigmine in divided doses with 0. 01 mg/kg and 0.04 mg/kg did not produce a significantly faster reversal of residual vecuronium-induced neuromuscular blockade as compared to a single bolus administration.
Neostigmine* ; Neuromuscular Blockade ; Vecuronium Bromide*

The methods commonly used for monitoring neuromuscular transmission do not allow evaluating of an intense neuromuscular blockade. A sufficient dose of non-depolarizing relaxant used for endotracheal intubation causes disappearance of the response to single, tetanic and train of four (TOF)nerve stimulation for a variable period of time during which the magnitude of neuro-muscular blockade can not be evaluated by the traditional stimulation forms. Enhancement of posttetanic twitch tension in partially curarized patients remains constant regardless of the dose of non-depolarizing muscle relaxant or magnitude of neuromuscular blockade. If this also holds true for an intense neuromuscular blockade, the response to posttetanic twitch stimulation after the injection of a non-depolarizing muscle relaxant must appear earlier than the response to pretetanic twitch or TOF neve stimulation. The present study was designed to evaluate neuromuscular blockade during the period of no response to single or TOF stimulation by quantifying the degree of posttetanic potentiation. The possibility existed that the relatively frequent use of a tetanic stimulation (every 6 minutes) might have influenced the recovery of neuromuscular blockade. Therefore, we have studied the conventional TOF stimulation comparing with posttetanic count stimulation which may affect the recovery of intravenous pancuronium(0.08 mg/kg) induced neuromuscular block. The results were as follows; 1) The time of the T1 appearance was 815 seconds and 50% T4 ratio was 1,214.3 seconds in TOF group. 2) The time of the T1 appearance was 790 seconds and 50% T4 ratio was l,l35.5 seconds in PTC group, The recovery time appeared to be shorter in this group but statistically not signifi cant. 3) ln PTC group, TOF recovery was observed after average 2.3 times of tetanic stimulation. Above findings may suggest that intense pancuronium block in rabbit is not affeced by the TOF or PTC stimulation.
Humans ; Intubation, Intratracheal ; Neuromuscular Blockade* ; Pancuronium

No abstract available.
Eclampsia* ; Female ; Humans ; Magnesium* ; Neuromuscular Blockade* ; Pregnancy

BACKGROUND: The timing of administration may be an important factor in order to obtain maximal antagonizing effect of anticholinesterase on neuromuscular blockade. The objective of this study is to seek for the optimal administration time of pyridostigmine for reducing the recovery time of vecuronium. METHODS:Thirty patients were devided into three groups,who were receiving intravenously pyridostigmine (0.2 mg/kg) at 10% (group 1), 20% (group 2) and 25% (group 3) recovery of T1. The recovery indices (RI: time taken for T1 to recover from 25 to 75% of control) and recovery time (time taken for T1 to recover from 5% to 20, 25, 50 & 75%) in vecuronium (0.1 mg/kg) neuromuscular blockade were checked and compared between 3 groups using train of four stimulation with Relaxograph(Datex co., Finland). RESULTS: The recovery time (T5-20, T5-25, T5-50, T5-75) was significantly faster in the group 1 than the group 3. But there were no significant differences in recovery indices (RI) between 3 groups. CONCLUSIONS: Provided there is a slightest evidence of spontaneous recovery, early administration of anticholinesterse will reduce the recovery time of nondepolarizing neuromuscular block. But it can not affect the dissociation rate of vecuronium (KD) and there were no significant differences in recovery indices.
Humans ; Neuromuscular Blockade* ; Pyridostigmine Bromide* ; Vecuronium Bromide

BACKGROUND: Sugammadex is a novel neuromuscular reversal agent, but its associated hypersensitivity reaction and high cost have been obstacles to its widespread use. In the interest of reducing the necessary dosage of sugammadex, the reversal time of the combined use of sugammadex and neostigmine from moderate neuromuscular blockade were investigated. METHODS: The patients enrolled ranged in age from 18 to 65 years old with American Society of Anesthesiologists class 1 or 2. The subjects were randomly assigned into one of the four groups (Group S2, S1, SN, and N; n = 30 per group). The reversal agents of each groups were as follows: S2 - sugammadex 2 mg/kg, S1 - sugammadex 1 mg/kg, SN - sugammadex 1 mg/kg + neostigmine 50 microg/kg + glycopyrrolate 10 microg/kg, N - neostigmine 50 microg/kg + glycopyrrolate 10 microg/kg. The time to recovery of the train-of-four (TOF) ratio was checked in each group. RESULTS: The time to 90% recovery of TOF ratio was 182.6 +/- 88.9, 371.1 +/- 210.4, 204.3 +/- 103.2, 953.2 +/- 379.7 sec in group S2, S1, SN and N, respectively. Group SN showed a significantly shorter recovery time than did group S1 and N (P < 0.001). However, statistically significant differences between the S2 and SN groups were not be observed (P = 0.291). No hypersensitivity reactions occurred in all groups. CONCLUSIONS: For the reversal from rocuronium-induced moderate neuromuscular blockade, the combined use of sugammadex and neostigmine may be helpful to decrease the recovery time and can also reduce the required dosage of sugammadex. However, the increased incidence of systemic muscarinic side effects must be considered.
Glycopyrrolate ; Humans ; Hypersensitivity ; Incidence ; Neostigmine* ; Neuromuscular Blockade*