The influence of bile salts on the duration of action of the steroidal non-depolarizing neuromuscular blocking agent ORG 6368 was investigated in cats. The intravenous administration of ORG 6368 (100 microgram/kg body wt) caused a maximum neuromuscular blockade of 71 +/- 6% with a duration of action of 3.4 +/- 0.1 min. However, intraportal administration of the same dose caused no significant n...

Despite the significant improvements in the pharmacology of muscle relaxants in the past six decades, the search for the ideal muscle relaxant continues, mainly because of the incomplete efficacy and persistent side effects associated with their antagonism. Clinical concerns remain about the residual paralysis and hemodynamic side effects associated with the classic pharmacologic reversal agent...

We read with appreciation and concern the review article by Isenstein et al,’ which appeared in the October 1992 issue of Chest. The authors have provided clinically relevant information that is familiar to most anesthesiologists, but it may not be the case for other specialists. With more newly available drugs and better monitoring techniques, there is a current trend toward increasing usage o...

Histamine release by neuromuscular blocking agents Sir,—The design of the study by Naguib and colleagues [1] on the histamine releasing potencies of various neuromuscular blocking drugs resulted in cardiovascular changes which were profound, adverse and predictable. For example, the data sheet for mivacurium suggests administration over 5–15 s. The authors chose 5 s, despite quoting references ...

[This corrects the article on p. 500 in vol. 70, PMID: 29046769.].

Myasthenia gravis is a neuromuscular disease with multisystemic involvement and multiple drug interactions not restricted to blockers, but also including anaesthetic analgesic agents, increasing the risk of anaesthesia-related complications. In this case report, we describe our safe effective technique for Gravis patient submitted Video-Assisted Thoracoscopy thymectomy, requiring block. Since a...

Purpose: Anaesthetic practice for caesarean section (C&S) has changed during the last decades. Although, general anesthesia (GA) for C&S still seems to be the method of choice in extremely urgent settings, past anesthetic evidence has shown that GA is with increased risk of anesthesia-related maternal and neonatal mortality. Rocuronium bromide (RB) provides the shortest onset of action of nonde...

Introduction. Maintenance dosing of neuromuscular blocking agents is complex and varies with patient, procedure, and clinical situation. With this in mind, we sought to identify factors impacting the maintenance dosing of neuromuscular blockers as a step toward identifying best practice with respect to minimizing residual neuromuscular blockade. Methods. Cases utilizing rocuronium from July 1, ...