Background: Residual neuromuscular blockade (RNMB) is a frequent event after general anesthesia, which can lead to serious complications, such as upper airway obstruction. Sugammadex is useful in reversing RNMB. However, its use in infants has not yet been approved by the Food and Drug Administration. Therefore, anesthesiologists can be hesitant use it, even in situations where no other choice is available.
Case: A two-month-old baby presented to the hospital for umbilical polypectomy. At the end of the surgery, neostigmine was administered. Even after waiting for 30 min and injecting an additional dose of neostigmine, neuromuscular blockade was not adequately reversed. Eventually, sugammadex was administered, and spontaneous breathing returned.
Conclusions: If there were no particular causes of delayed return to spontaneous breathing in infants, RNMB should be considered and reversal with sugammadex would be useful.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8841263 | PMC |
http://dx.doi.org/10.17085/apm.21071 | DOI Listing |
Prehosp Emerg Care
January 2025
Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Objectives: Prehospital endotracheal intubation (ETI) is a lifesaving procedure with known complications. To reduce ETI-associated morbidity and mortality, organizations prioritize first-pass success (FPS). However, there are few data evaluating the association of FPS with clinician licensure.
View Article and Find Full Text PDFBr J Clin Pharmacol
January 2025
Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics. College of Pharmacy, University of Florida, Orlando, FL, USA.
Aims: Residual neuromuscular blockade (RNB) commonly occurs when using neuromuscular blockers and increases the risk for pulmonary complications, such as airway obstruction and severe hypoxemia, in extubated patients. Rocuronium exhibits a high variability in recovery time, contributing to an increased risk for RNB. This study aimed to identify and characterize the sources of variability in rocuronium exposure and response via a population pharmacokinetic/pharmacodynamic (PK/PD) analysis and to apply the developed PK/PD model to investigate clinical implications.
View Article and Find Full Text PDFMed 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 PDFBMC Anesthesiol
January 2025
Department of Anesthesiology, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215124, China.
Background: Intravenous anesthesia with high-flow nasal cannula (HFNC) has been reported to benefit oxygen reserves and enhance postoperative recovery in surgeries requiring low neuromuscular blockade. This study investigated whether HFNC improves recovery quality in elderly undergoing ureteroscopic holmium laser lithotripsy (UHLL).
Methods: We enrolled 106 elderly patients undergoing UHLL, with 96 patients (48 per group) included in the final analysis.
Med Sci Monit
January 2025
Department of Nephrology, Transplantology and Internal Diseases, Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!