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Examining PACU Nurse Knowledge and Confidence of Neuromuscular Blocking Drugs and Neuromuscular Blocking Reversal Agents.
J Perianesth Nurs
January 2025
Ellmer School of Nursing Mason and Joan Brock Virginia Health Sciences, Old Dominion University, Virginia Beach, VA. Electronic address:
Purpose: neuromuscular blockade (NMB) remains a significant risk for patients after anesthesia. This study examines the confidence and knowledge of the use and side effects of NMB and associated reversal agents amongst postanesthesia care unit (PACU) nurses caring for the postanesthesia surgical population. Retrospective data on the incidence and demographics of patients who underwent general anesthesia with NMB were also examined.
View Article and Find Full Text PDFImpact of Liver Disease on Use of Muscle Relaxants in Anesthesia: A Comprehensive Review.
Med Sci Monit
January 2025
Department of Nephrology, Transplantology and Internal Diseases, Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland.
Article Synopsis
- Skeletal muscle relaxants are commonly used in anesthesia for surgeries, mechanical ventilation, and intubation, creating a conduction block at the neuromuscular junction.
- Reversal agents, like neostigmine and sugammadex, help terminate the neuromuscular blockade and prevent residual effects, but their efficacy can be affected by liver and kidney dysfunction.
- Liver damage, which can stem from various causes including drug toxicity and metabolic disorders, impairs drug metabolism and can lead to systemic complications, ultimately impacting the use of muscle relaxants in patients with liver disease.
Evaluation of Subetadex-α-methyl, a Polyanionic Cyclodextrin Scaffold, as a Medical Countermeasure against Fentanyl and Related Opioids.
ACS Cent Sci
December 2024
Physical and Life Sciences Directorate, Biosciences and Biotechnology Division, Global Security Directorate, Forensic Science Center, and Materials Science Division, Lawrence Livermore National Laboratory, Livermore, California 94550, United States.
Subetadex-α-methyl (SBX-Me), a modified, polyanionic cyclodextrin scaffold, has been evaluated for its utilization as a medical countermeasure (MCM) to neutralize the effects of fentanyl and related opioids. Initial toxicity assays demonstrate that SBX-Me has a nontoxic profile, comparable to the FDA-approved cyclodextrin-based drug Sugammadex. Pharmacokinetic analysis showed rapid clearance of SBX-Me with an elimination half-life of ∼7.
View Article and Find Full Text PDFBackground: With the clinical integration of sugammadex, a selective relaxant-binding agent, the approach to reversing neuromuscular blockade is revolutionized. Despite its efficacy, sugammadex's adverse reactions range from mild symptoms to severe cases, including anaphylaxis and coagulopathy. Assessing the nature of these reactions using the Food and Drug Administration's Adverse Event Reporting System (FAERS) database is vital for safe anesthetic practice.
View Article and Find Full Text PDFFactors Associated With Decision to Use and Dosing of Sugammadex in Children: A Retrospective Cross-Sectional Observational Study.
Anesth Analg
January 2025
From the Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan.
Background: Sugammadex was initially approved for reversal of neuromuscular blockade in adults in the United States in 2015. Limited data suggest sugammadex is widely used in pediatric anesthesia practice however the factors influencing use are not known. We explore patient, surgical, and institutional factors associated with the decision to use sugammadex versus neostigmine or no reversal, and the decision to use 2 mg/kg vs 4 mg/kg dosing.
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