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Skeletal Muscle Relaxants and Their Impact on Intracranial Pressure in Neurosurgery.
Med Sci Monit
January 2025
Department of Rheumatology, University Clinical Hospital No. 1 Szczecin, Szczecin, Poland.
Skeletal muscle relaxants have their place in everyday use in numerous anesthesiological procedures, such as preparing a patient for surgery, supporting mechanical ventilation, and performing effective intubation. These drugs can be divided, based on their mechanism of action, into depolarizing skeletal relaxants, such as succinylcholine, and non-depolarizing skeletal muscle relaxants. Non-depolarizing agents are further categorized, based on their structure, into steroidal (eg, rocuronium) and benzylisoquinoline (eg, atracurium) compounds.
View Article and Find Full Text PDFTrichostatin A reverses rocuronium resistance in burn-injured rats.
Burns
December 2024
Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China. Electronic address:
Aims: This study aimed to investigate whether the histone deacetylase HDAC4 inhibitor, trichostatin A (TSA), could reverse resistance to non-depolarizing muscle relaxants (NDMRs) caused by burn injuries.
Materials And Methods: A rat burn injury model was established, in which TSA was administered to inhibit HDAC4 expression. The potency of rocuronium was assessed through tension tests, and the levels of HDAC4 and myogenin proteins were determined using Western blot.
Neuromuscular Blockade Reversal with Sugammadex Reduces Cardiac Complications and OR Time for Prone Lumbar Spinal Fusion Compared to Neostigmine.
Spine (Phila Pa 1976)
December 2024
Brown University Department of Orthopaedic Surgery, Providence, Rhode Island.
Study Design: Retrospective cohort study.
Objective: To evaluate inpatient complication profiles of patients receiving neuromuscular blockade reversal via sugammadex versus neostigmine/glycopyrrolate.
Summary Of Background Data: Sugammadex is a neuromuscular blockade reversal agent that binds non-depolarizing muscle relaxants.
Management of masseter spasm after induction of general anaesthesia in a patient with depressive disorder on selective serotonin reuptake inhibitor treatment.
Pak J Med Sci
December 2024
Syeda Rimza Ali, MBBS, Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan.
Article Synopsis
- - Masseter spasm is defined as significant difficulty in opening the mouth after anaesthesia induction, which can complicate procedures like laryngoscopy and intubation, and occurs without any issues from the jaw joint.
- - Factors such as certain muscle relaxants, antidepressants, and high anxiety levels can contribute to the occurrence of masseter spasms.
- - This case highlights the need for anaesthesiologists to be cautious of masseter spasm risks in anxious patients undergoing antidepressant treatment, as it can create dangerous situations where ventilation and intubation are impossible.
Failure of neuromuscular blockade despite high doses of rocuronium and atracurium in a patient with colorectal carcinoma: A case report.
Eur J Anaesthesiol
January 2025
From the Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland (ADSR, MB, RS, GA, ES), Department of Anaesthesia, Northern Lisbon University Hospital Centre, Lisbon, Portugal (ADSR), University Clinic of Anesthesiology and Reanimation, Faculty of Medicine, University of Lisbon, Portugal (ADSR), Division of Clinical Pharmacology and Toxicology, Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, Geneva, Switzerland (AN).
Resistance to the effects of rocuronium and other neuromuscular blocking agents (NMBA) has been previously reported, including delayed onset of relaxation, rapid recovery and incomplete paralysis under recommended doses. These conditions have been associated with denervation injury, burns, immobilisation, infections, metabolic disorders, and drug interactions. In this report, we describe the case of a young male without any known pre-disposing factor for NMBA resistance, who failed to attain muscle relaxation with non-depolarising NMBA despite high doses of rocuronium and atracurium during two surgeries for colorectal cancer, several months apart.
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