BACKGROUND A model of an antegrade, perfused, isolated rat peroneal nerve anterior tibial muscle was developed to study potentially important factors governing the time course of action of (nondepolarizing) neuromuscular blocking agents such as concentration, blood flow, and temperature. The model allows observation of the effects of selective changes in these factors. METHODS The authors iso...

INTRODUCTION Anesthetic management of patients with Duchenne muscular dystrophy (DMD) is complicated because these patients are more sensitive to nondepolarizing neuromuscular blocking agents (NMBAs) and are vulnerable to postoperative complications, such as postoperative residual curarization and respiratory failure. Sugammadex is a new reversal agent for aminosteroidal NMBAs, but its safety i...

Myasthenia gravis, a disorder of neuromuscular transmission, presents a unique challenge to the perioperative anesthetic management of morbidly obese patients. This report describes the case of a 27-year-old morbidly obese woman with a past medical history significant for myasthenia gravis and fatty liver disease undergoing bariatric surgery. Anesthesia was induced with intravenous agents and m...

The interaction of four inhalational anesthetics (sevoflurane, isoflurane, enflurane and halothane) with pancuronium and vecuronium and also their prejunctional actions at the neuromuscular junction were quantitatively studied using rat phrenic nerve-hemidiaphragm preparations. To investigate the prejunctional effects of inhalational anesthetics, a train-of-four ratio (T4/T1) and the tetanus ra...

The potential changes In neuromuscular blockade after chronic (>24 h) administration of sub-paralytic doses of two newly introduced aminosteroidal muscle relaxants were investigated. Org-9426 (rocuronium) and Org-9487 were studied in the in vivo guinea pig gastrocnemius muscle-sciatic nerve preparation. The problems seen after prolonged administration of muscle relaxants are thought to ari...

Cyclodextrins are molecules with a hollow, truncated cone shape that possess unique lipophilic and hydrophilic properties. These unique properties enable cyclodextrins to engulf and bind lipophilic molecules while maintaining aqueous solubility. Encapsulation of molecules is the principal action of a new drug class, selective relaxant binding agents, which binds and inactivate aminosteroid nond...

the potential changes in neuromuscular blockade after chronic (>24 h) administration of sub-paralytic doses of two newly introduced aminosteroidal muscle relaxants were investigated. org-9426 (rocuronium) and org-9487 were studied in the in vivo guinea pig gastrocnemius muscle-sciatic nerve preparation. the problems seen after prolonged administration of muscle relaxants are thought to arise fr...

Huntington’s disease (HD), a rare, autosomal dominant disorder of the central nervous system, has been associated at times with unusual responses to anesthetic agents such as thiopental, midazolam, succinylcholine, and nondepolarizing neuromuscular blocking drugs. We describe the anesthetic management of a 50 year-old female with advanced HD, complicated by chorea, dementia, dysphagia, and dysa...

Prolonged neuromuscular blockade from succinylcholine after neostigmine administration has been reported in patients with frank renal failure. We present a case of prolonged neuromuscular blockade from succinylcholine administration, given 2 hours after neostigmine reversal of neuromuscular blockade in a patient with chronic renal insufficiency. This case shows that patients with chronic renal ...

Contrary to popular belief, the elimination of active drug by renal excretion is a relatively unimportant mechanism for the termination of drug action. Most drugs are weak electrolytes which are lipid-soluble in the un-ionized state, and as such they cannot be excreted by the kidney because they are extensively reabsorbed. These lipid-soluble drugs are invariably metabolized to more water-solub...