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A Review of Muscle Relaxants in Anesthesia in Patients with Neuromuscular Disorders Including Guillain-Barré Syndrome, Myasthenia Gravis, Duchenne Muscular Dystrophy, Charcot-Marie-Tooth Disease, and Inflammatory Myopathies.
Med Sci Monit
December 2024
Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Collegium Medicum University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
Anesthesia management in neuromuscular diseases (NMDs) is a complex challenge, requiring careful preoperative evaluation, tailored treatment strategies, and vigilant perioperative monitoring. This review examines the nuances of anesthesia in patients with NMD, addressing potential complications such as intubation difficulties, respiratory failure, and adverse effects of anesthetics and neuromuscular conduction blocking agents (NMBAs). Nondepolarizing NMBAs, including steroidal agents and benzylisoquinolines, are analyzed for their role, risks, and optimal use based on procedural requirements and patient characteristics.
View Article and Find Full Text PDFCaution for psychiatrists: malignant hyperthermia risks with the anesthetic agent succinylcholine (Suxamethonium) during electroconvulsive therapy.
BMC Psychiatry
June 2024
Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, 160-8582, Japan.
Background: Malignant hyperthermia is a potentially lethal condition triggered by specific anesthetic drugs, especially a depolarizing muscle relaxant of succinylcholine (Suxamethonium). Despite the frequent use of succinylcholine with electroconvulsive therapy (ECT), there has been no reported case of potentially lethal malignant hyperthermia following ECT. In addition, the time interval between the administration of succinylcholine and the onset of malignant hyperthermia has not been outlined in the context of ECT.
View Article and Find Full Text PDFEffectiveness of implementing a standardized perioperative pain management protocol in children undergoing tonsillectomy: A quality improvement project.
Paediatr Anaesth
August 2024
Associate Professor and Assistant Dean of Immersive Learning and Digital Innovation, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
Background And Purpose: Tonsillectomy procedures are commonly performed worldwide. At our academic tertiary care facility, we perform approximately 1000 tonsillectomy procedures annually. We have found inconsistent pain management strategies in pediatric tonsillectomy patients have contributed to variability in postoperative complications and the number and types of postoperative pain medications required in the Post Anesthesia Care Unit (PACU).
View Article and Find Full Text PDFRisk Factors for Postoperative Urinary Retention After Lumbar Fusion Surgery: Anesthetics and Surgical Approach.
J Am Acad Orthop Surg
December 2023
From the Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA (Heard, Lee, Ezeonu, Dees, Wiafe, Wright, Toci, Canseco, Kaye, Kurd, Hilibrand, Vaccaro, Schroeder, and Kepler), the Department of Orthopaedic Surgery, Washington University, St. Louis, MO (Lambrechts), and the Department Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA (Schwenk).
Introduction: Postoperative urinary retention (POUR) after lumbar fusion surgery can lead to longer hospital stays and thus increased risk of developing other postoperative complications. Therefore, we aimed to determine the relationship between POUR and (1) surgical approach and (2) anesthetic agents, including sugammadex and glycopyrrolate.
Methods: After institutional review board approval, L4-S1 single-level lumbar fusion surgeries between 2018 and 2021 were identified.
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