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Navigating Anesthesia: Muscle Relaxants and Reversal Agents in Patients with Renal Impairment.
Med Sci Monit
August 2024
Department of Nephrology, Transplantology and Internal Diseases, Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland.
This comprehensive review explores the interaction between neuromuscular blocking agents, reversal agents, and renal function, focusing on various drugs commonly used in anesthesia and their effects on kidney health. Succinylcholine, commonly used for anesthesia induction, can trigger elevated potassium levels in patients with specific medical conditions, leading to serious cardiac complications. While studies suggest the use of succinylcholine in patients with renal failure is safe, cases of postoperative hyperkalemia warrant further investigation.
View Article and Find Full Text PDFNew Sulfonate Ester-Linked Fluorinated Hydrazone Derivatives as Multitarget Carbonic Anhydrase and Cholinesterase Inhibitors: Design, Synthesis, Biological Evaluation, Molecular Docking and ADME Analysis.
Chem Biodivers
December 2024
Department of Biochemistry, Faculty of Pharmacy, Ağrı Ibrahim Çecen University, 04100, Ağrı, Türkiye.
In this study, some new hydrazone derivatives (2a-g) was designed, synthesized for first time, and evaluated as multitarget inhibitors of AChE, BChE, hCA I and hCA II. The chemical structures of new hybrids were confirmed by elemental analysis and some spectroscopic techniques. All tested compounds showed low nanomolar inhibition with IC values of in the range of 30.
View Article and Find Full Text PDFFactors Influencing Neuromuscular Blockade Reversal Choice in the United States Before and During the COVID-19 Pandemic: Retrospective Longitudinal Analysis.
JMIR Perioper Med
July 2024
Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Background: Neuromuscular blockade (NMB) agents are a critical component of balanced anesthesia. NMB reversal methods can include spontaneous reversal, sugammadex, or neostigmine and the choice of reversal strategy can depend on various factors. Unanticipated changes to clinical practice emerged due to the COVID-19 pandemic, and a better understanding of how NMB reversal trends were affected by the pandemic may help provide insight into how providers view the tradeoffs in the choice of NMB reversal agents.
View Article and Find Full Text PDFAssociation between reversal agents (sugammadex vs. neostigmine) for neuromuscular block and postoperative pulmonary complications: A retrospective analysis.
Br J Clin Pharmacol
July 2024
Department of Anesthesiology, Jiangnan University Medical Center (Wuxi No.2 People's Hospital of Nanjing Medical University), Wuxi, Jiangsu Province, China.
Aims: Residual neuromuscular blockade has been linked to pulmonary complications in the postoperative period. This study aimed to determine whether sugammadex was associated with a lower risk of postoperative pulmonary complications (PPCs) compared with neostigmine.
Methods: This retrospective cohort study was conducted in a tertiary academic medical center.
Association of Intravenous Neostigmine and Anticholinergics or Sugammadex with Postoperative Delirium: A Retrospective Cohort Study.
Anesth Analg
January 2025
From the Departments of Outcomes Research.
Background: Administration of cholinesterase inhibitors in combination with anticholinergic drugs for reversal of neuromuscular blocks may precipitate delirium through impairment of central cholinergic transmission, which could be avoided by using sugammadex. Therefore, we tested the primary hypothesis that postoperative delirium is less common when neuromuscular block is reversed with sugammadex than with neostigmine combined with glycopyrrolate or atropine.
Methods: We conducted a single-center retrospective cohort study, analyzing all adult patients having general anesthesia for noncardiac surgery who received neostigmine or sugammadex from January 2016 to March 2022.
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