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The Dosage of Muscle Relaxants in Morbidly Obese Patients in Daily Practice - A Narrative Review.
Int J Gen Med
September 2024
Department of Anaesthesiology and Intensive Care, Regional Specialist Hospital in Olsztyn, Olsztyn, Poland.
The prevalence of morbid obesity in today's population around the world is alarming. Morbid obesity involves substantial changes in body composition and function, which can affect the pharmacodynamics and pharmacokinetics of many drugs. This paper aims to discuss the application of muscle relaxants and their reversing agents in patients with morbid obesity.
View Article and Find Full Text PDF[Update: Neuromuscular Blockade during General Anesthesia].
Anasthesiol Intensivmed Notfallmed Schmerzther
August 2024
The correct use of muscle relaxants and neuromuscular monitoring during anesthesia has been subject of controversial discussions for decades. Particularly important in clinical practice are identification and management of residual neuromuscular blockages and avoidance of associated complications. Despite the differences in the molecular mechanisms of action between depolarizing and non-depolarizing muscle relaxants the blockade of the postsynaptic nicotinic acetylcholine receptor remains a common ending pathway.
View Article and Find Full Text PDFBarriers and aids to routine neuromuscular monitoring and consistent reversal practice-A qualitative study.
Acta Anaesthesiol Scand
September 2020
Copenhagen Academy for Medical Education and Simulation and University of Copenhagen, Copenhagen, Denmark.
Background: Neuromuscular monitoring is recommended whenever a neuromuscular blocking agent is administered, but surveys have demonstrated inconsistent monitoring practices. Using qualitative methods, we aimed to explore barriers and aids to routine neuromuscular monitoring and consistent reversal practice.
Methods: Focus group interviews were conducted to obtain insights into the thoughts and attitudes of individual anaesthetists, as well as the influence of colleagues and department culture.
Effects of Neostigmine and Sugammadex for Reversal of Neuromuscular Blockade on QT Dispersion Under Propofol Anesthesia: A Randomized Controlled Trial.
Cardiol Ther
December 2018
Department of Anesthesiology, Dokkyo Medical University, School of Medicine, Mibu, Tochigi, Japan.
Introduction: Reversal of non-depolarizing neuromuscular blocking agent neostigmine is associated with QT prolongation under general anesthesia. To clarify the effects of neostigmine and sugammadex on hemodynamic status, the QT interval and QT dispersion after reversal of neuromuscular blockade were evaluated with a 12-lead electrocardiogram. To exclude QT prolongation due to sevoflurane, the present study was performed under propofol anesthesia.
View Article and Find Full Text PDFPeri-operative Medication Dosing in Adult Obese Elective Surgical Patients: A Systematic Review of Clinical Studies.
Clin Drug Investig
August 2018
Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania, Pharmacy Building, Dobson Road, Private Bag 26, Hobart, TAS, 7001, Australia.
Background: Despite the increasing numbers of obese patients undergoing elective surgery, there is a lack of evidence-based dosing guidelines for peri-operative medications in obesity.
Objective: The objective was to systematically review the dosing and outcomes of peri-operative medications used in obese elective surgical patients.
Methods: Medical subject headings and general keywords were used to systematically search multiple databases (PubMed, EMBASE, Cochrane Library and CINAHL).
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