A review of the interest of sugammadex for deep neuromuscular blockade management in Belgium.

Oro-tracheal intubation and selected surgical conditions are facilitated by a deep neuromuscular block (NMB), but patient's security can be jeopardized by its residual effects at the time of tracheal extubation. Although neostigmine remains the reference reversal agent in many situations, the limitations of its efficacy must be well understood (ceiling effect, delay of action, side effects). It is best administered after re-emergence of the 3rd or 4th train-of-four (TOF) response.

Long-lasting potentiation of a single-dose of rocuronium by amikacin: case report.

We report for the first time to our knowledge long-lasting (4 hours) potentiation of single intubating dose of rocuronium by a single bolus of amikacin given 55 minutes later in a woman having no precipitating factor (renal failure, hepatic failure, ionic disorder, other drugs influencing neuromuscular function). This patient had received the same rocuronium dose one month sooner in similar circumstances (without aminoglycoside antibiotic drug) and had not presented any prolonged neuromuscular blockade at this time. Neuromuscular blockade should be monitored in every patient receiving aminoglycoside antibiotic with even a single intubating dose of neuromuscular blocking drug.

Installation of the hand influences acceleromyography measurement. A comparison with mechanomyography during neuromuscular recovery.

Acceleromyography is commonly used to monitor perioperative neuromuscular blockade and to prevent residual neuromuscular blockade at the time of tracheal extubation. However, there are problems associated with this method, such as obtaining stable values, particularly beneath the surgical fields. We compared TOF ratios obtained on both hands simultaneously using on one side mechanomyography and on the other acceleromyography, installed in four different ways: the hand simply lying on a board, fingers fixed with tape, use of the hand adaptor or the TOF-tube.

TOF-tube, a new protection for acceleromyography, compared with the TOF-Guard/TOF-Watch arm board.

Neuromuscular blockade monitoring at the adductor pollicis has become easier using acceleromyography. In order to guarantee a reliable analysis of its acceleration, the thumb movement has to be free and protected from external influences. To this end, we describe here-in two hand fixation- and protection-devices for use with acceleromyography.