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Effect of total intravenous anesthesia versus sevoflurane anesthesia on intraoperative facial nerve monitoring: a randomized controlled trial.
Can J Anaesth
November 2024
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 06351, Republic of Korea.
Purpose: Intraoperative facial nerve monitoring (IFNM) facilitates effective nerve preservation during ear and head and neck surgeries. Quantitative differences in the timely feasibility of IFNM during total intravenous anesthesia (TIVA) vs sevoflurane anesthesia have not been investigated.
Methods: We conducted a randomized controlled trial in which 98 patients undergoing ear surgery were allocated to either the TIVA or sevoflurane group.
Emerging evidence suggests that many conventional anticonvulsants, such as carbamazepine, phenytoin, and valproic acid, could cause cross-resistance to nondepolarizing muscle relaxants. However, there are few reports describing the interactions between levetiracetam and rocuronium. This case report describes the delayed onset of rocuronium in an adult patient with intractable epilepsy on long-term levetiracetam therapy.
View Article and Find Full Text PDFImpact of deep neuromuscular blockade on intraoperative NOL-guided remifentanil requirement during desflurane anesthesia in laparoscopic colorectal surgeries: A randomised controlled trial.
J Clin Anesth
December 2024
Department of Anesthesiology and Pain Medicine, Maisonneuve-Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, Montréal, Canada; Research Centre of the Maisonneuve-Rosemont Hospital, CIUSSS de l'Est de l'Ile de Montréal, Montréal, Canada; Department of Anesthesiology and Pain Medicine, University of Montréal, Canada.
Article Synopsis
- The study aimed to assess how deep neuromuscular blockade (NMB) affects pain and opioid use during laparoscopic colorectal surgery compared to moderate NMB.
- 100 patients were randomly divided into deep and moderate NMB groups, with the deep group requiring significantly less remifentanil (an opioid) during surgery.
- Results indicated that deep NMB improved surgical conditions, evidenced by a better Leiden Surgical Rating Scale and lower intra-abdominal pressure, while postoperative pain and analgesic use were similar to the moderate group.
Train-of-four ratio, counts and post tetanic counts with the Tetragraph electromyograph in comparison to mechanomyography.
J Clin Monit Comput
October 2024
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA.
Automated EMG devices to detect compound muscle action potentials from the adductor pollicis muscle in response to ulnar nerve stimulation, regardless of hand and thumb position, may serve as a better reference ("gold standard") for clinical assessment of neuromuscular function than traditional mechanomyography (MMG) systems that need custom design and validation in lab settings. This evaluation compared the TetraGraph EMG system against a validated MMG device to investigate the accuracy and repeatability of this quantitative EMG monitor for detecting onset, offset and deep neuromuscular block. Simultaneous muscle action potential recordings from the EMG neuromuscular monitor and muscle contractions from an in-house developed MMG monitor in response to ulnar nerve stimulation were obtained from patients having elective surgery requiring neuromuscular block.
View Article and Find Full Text PDFIs quantitative neuromuscular monitoring mandatory after administration of the recommended dose of sugammadex? A prospective observational study.
Anaesth Crit Care Pain Med
December 2024
Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address:
Background: Some anaesthetists wonder whether confirming a train-of-four ratio (TOFR) ≥0.9 is necessary when using sugammadex to antagonise neuromuscular blockade (NMB). In this study, we aimed to determine whether using sugammadex at the recommended dose under neuromuscular monitoring (NMM) would ensure complete recovery, even without further NMM.
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