BACKGROUND A safe and effective ultra-short-acting nondepolarizing neuromuscular blocking agent is required to block nicotinic receptors to facilitate intubation. Rapacuronium, which sought to fulfill these criteria, was withdrawn from clinical use due to a high incidence of bronchospasm resulting in death. Understanding the mechanism by which rapacuronium induces fatal bronchospasm is imperati...

OBJECTIVE To investigate facial nerve monitoring in patients receiving the partial nondepolarizing neuromuscular blocking agents (NMBAs), remifentanil and propofol. METHODS Patients with normal facial function and advanced middle-ear disease were enrolled. For total intravenous anaesthesia (TIVA), propofol and remifentanil were infused as induction/maintenance anaesthesia. Stimulation thresho...

The comments of Drs. Maxwell and Mihm invite a further discussion of diuretic use in the setting of postoperative negative-pressure pulmonary edema (NPPE). Although diuretics were administered to the patient in our case, as originally stated, it is debatable whether this therapy benefited the patient in the case scenario. In NPPE, the primary problem is not fluid overload but a combination of n...

Neuromuscular blockade, induced by neuromuscular blocking agents, has allowed prescribed immobility, improved surgical exposure, optimal airway management conditions, and facilitated mechanical ventilation. However, termination of the effects of neuromuscular blocking agents has, until now, remained limited. A novel cyclodextrin encapsulation process offers improved termination of the paralytic...

BACKGROUND Systemic inflammation may be associated with resistance to nondepolarizing neuromuscular blocking drugs, the mechanisms of which are, however, uncharacterized. The authors therefore investigated the pharmacodynamics of atracurium and its relation to the expression of nicotinic acetylcholine receptors and alpha1 -acid glycoprotein in a rat model of systemic inflammation. METHODS To ...

28 28 GENERIC NAME PAGE 4-Aminopyridine 340 Atracurium 343 Baclofen 344 Botulinum toxin A 340 Cyclobenzaprine 345 Dantrolene 344 3,4-Diaminopyridine 340 Diazepam 344 GENERIC NAME PAGE Guanidine 340 Mivacurium 343 Pancuronium 343 Rapacuronium 343 Rocuronium 343 Succinylcholine 341 d-Tubocurarine 342 Vecuronium 343 Neuromuscular transmission involves the events leading from the liberation of acet...

Neostigmine has been traditionally used as the agent of choice to reverse Neuromuscular Blockade (NMB) after muscle paralysis during general anesthesia. However, the use of neostigmine has not been without untoward events. Sugammadex is a novel drug that selectively binds to aminosteroid nondepolarizing muscle relaxants and reverses even a deep level of NMB. Controversy exists regarding the opt...