Patients with traumatic brain injury (TBI) require mechanical ventilation for airway protection, to reduce work of breathing, to reduce cerebral metabolic rate and to optimize intracerebral hemodynamics. Drugs like narcotics, benzodiazepines, propofol and alpha-2 agonists with or without non-depolarizing muscle relaxants are used to facilitate mechanical ventilation. We reviewed literature on s...

Organophosphorus compounds, used as insecticides and agents of chemical warfare, are a major global cause of health problems. These irreversible inhibitors of cholinesterase produce three well-recognised clinical entities: the initial cholinergic phase, which is a medical emergency often requiring management in an intensive care unit; the intermediate syndrome, during which prolonged ventilator...

Muscle relaxants are routinely administered during anesthesia. The residual effects of nondepolarizing muscle relaxants must be reversed by the anesthesia provider prior to extubation of the trachea to ensure that patients can safely protect their own airways and maintain adequate ventilation. Many factors can potentiate the effects of muscle relaxants, and each of these factors must be taken i...

BACKGROUND Rapid sequence induction (RSI) is indicated in various situations. Succinylcholine has been the muscle relaxant of choice for RSI, and rocuronium has become an alternative medicine for patients who cannot be administered succinylcholine for various reasons. Although rocuronium has the most rapid onset time among non-depolarizing muscle relaxants, the standard dose of rocuronium (0.6 ...

Image courtesy of Dr John Thorpe 2. Please read the following passage. You receive a telephone call regarding a 30 year-old man about to undergo incision and drainage of a pilonidal abscess under general anaesthetic. His father had died unexpectedly following an appendicectomy. This led the anaesthetist to ask him some questions about his muscles. He said he had never been great at sport and he...

BACKGROUND We aimed to compare clinical effects of sugammadex versus combination of anticholinergic-anticholinesterase agents for reversing of nondepolarizing neuromuscular block in pediatric patients. MATERIALS AND METHODS A total of 60 pediatric patients whom should be performed general anesthesia in the supine position were enrolled to this randomized double-blinded clinical trial. Fentany...

BACKGROUND Neuromuscular blocking agents' detrimental airway effects may occur as a result of interactions with muscarinic receptors, allergic reactions, or histamine release. Rapacuronium, a nondepolarizing muscle relaxant, was withdrawn from clinical use because of its association with fatal bronchospasm. Despite its withdrawal from clinical use, it is imperative that the mechanism by which b...

BACKGROUND AND OBJECTIVES The priming technique is an alternative to shorten nondepolarizing neuromuscular blockers onset time. This study aimed at evaluating maximum neuromuscular block onset, tracheal intubation conditions and cardiocirculatory changes determined by different cisatracurium single or fractional doses. METHODS Participated in this study 80 patients physical status ASA I and I...