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Impact 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.
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 PDFRisk of Acute Complications with Rocuronium versus Cisatracurium in Patients with Chronic Kidney Disease: A Propensity-Matched Study.
Anesth Analg
October 2024
Department of Anesthesiology, The University of Texas Medical Branch, Galveston, Texas.
Article Synopsis
- Neuromuscular blocking agents (NMBAs) are crucial in anesthesia for procedures like intubation and mechanical ventilation, but they carry risks of acute complications, especially in patients with chronic kidney disease (CKD).
- A study used a large health database to compare the outcomes of two NMBAs - rocuronium with sugammadex and cisatracurium with neostigmine - in CKD patients, focusing on various complications within a week and mortality up to 30 days post-administration.
- The results showed that patients receiving rocuronium with sugammadex had significantly higher risks of respiratory failure, acute respiratory distress, hypertensive crisis, heart failure, pleural effusion, and a greater
Central cholinergic transmission modulates endocannabinoid-induced marble-burying behavior in mice.
Behav Brain Res
January 2025
Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Koni, Bilaspur, Chhattisgarh, India. Electronic address:
Central cholinergic system and endocannabinoid, anandamide exhibits anti-compulsive-like behavior in mice. However, the role of the central cholinergic system in the anandamide-induced anti-compulsive-like behavior is still unexplored. Therefore, the present study assessed the role of central cholinergic transmission in the anandamide-induced anti-compulsive activity using a marble-burying behavior (MBB) model in mice.
View Article and Find Full Text PDFElectroacupuncture treatment improves postoperative ileus by inhibiting the Th1 cell-mediated inflammatory response through the vagus nerve.
Acupunct Med
June 2024
Department of Anesthesiology, Shuguang Hospital Affiliated With Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Background: Electroacupuncture (EA) has been reported to improve intestinal motility in mice with postoperative ileus (POI). Previous studies, however, have yielded heterogeneous results regarding the effect of EA on POI.
Methods: Herein, a POI mouse model was constructed by intestinal manipulation.
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