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[PMID]:28448393
[Au] Autor:Boon M; Martini CH; Aarts LP; Torensma B; Dahan A
[Ad] Endereço:Department of Anesthesiology, Leiden University Medical Center, Leiden, the Netherlands, m.boon@lumc.nl.
[Ti] Título:Deep Neuromuscular Block and Surgical Conditions During Bariatric Surgery.
[So] Source:Anesth Analg;124(6):2094-2095, 2017 06.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Androstanóis
Bloqueio Neuromuscular
[Mh] Termos MeSH secundário: Cirurgia Bariátrica
Seres Humanos
Fármacos Neuromusculares não Despolarizantes
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Androstanols); 0 (Neuromuscular Nondepolarizing Agents)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002101


  2 / 2408 MEDLINE  
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[PMID]:28964314
[Au] Autor:Huh H; Park JJ; Kim JY; Kim TH; Yoon SZ; Shin HW; Lee HW; Lim HJ; Cho JE
[Ad] Endereço:Department of Anaesthesiology and Pain Medicine, Anam Hospital Korea University College of Medicine, Seoul, Republic of Korea.
[Ti] Título:Optimal dose of rocuronium bromide undergoing adenotonsillectomy under 5% sevoflurane with fentanyl.
[So] Source:Int J Pediatr Otorhinolaryngol;101:70-74, 2017 Oct.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Adenotonsillectomy is a short surgical procedure under general anaesthesia in children. An ideal muscle relaxant for adenotonsillectomy would create an intense neuromuscular block while having a quick recovery time without postoperative morbidity. We compared the effect of different doses of rocuronium for the tracheal intubation in children under 5% sevoflurane and fentanyl. MATERIALS AND METHODS: 75 children (aged 3-10 years, ASA I) scheduled for adenotonsillectomy were enrolled. Anaesthesia was induced with propofol 2.5 mg/kg, followed by fentanyl 2 µg/kg. After mask ventilation with 5 vol% sevoflurane in 100% oxygen for 2 min, 2 ml of study drug was administered intravenously, i.e., either normal saline (S Group) or one of two doses (0.15 or 0.3 mg/kg) of rocuronium. We assessed conditions during tracheal intubation and also recorded the surgical condition, the time from discontinuation of sevoflurane to extubation and PAED scale, pain scores in PACU. RESULTS: Rocuronium groups (96% and 100%, respectively; P < 0.01) showed statistically superior clinically acceptable intubating conditions than the saline group (72%). The 0.3 mg/kg rocuronium (80%) treatment clearly resulted in excellent intubating conditions compared with the 0.15 mg/kg group (44%; p = 0.028). There was no significant difference in the time to extubation and surgical condition, and in the postoperative measures of emergence delirium, pain, and recovery time among the three groups. CONCLUSION: A dose of 0.3 mg/kg rocuronium may provide optimal intubating conditions without delayed recovery in 5% sevoflurane anaesthesia with fentanyl in children undergoing adenotonsillectomy. CLINICAL TRIALS REGISTRY NUMBER: NCT02467595.
[Mh] Termos MeSH primário: Adenoidectomia/métodos
Androstanóis/administração & dosagem
Anestésicos Intravenosos/administração & dosagem
Fentanila/administração & dosagem
Éteres Metílicos/administração & dosagem
Fármacos Neuromusculares não Despolarizantes/administração & dosagem
Tonsilectomia/métodos
[Mh] Termos MeSH secundário: Adolescente
Extubação
Anestésicos Inalatórios/administração & dosagem
Criança
Pré-Escolar
Feminino
Seres Humanos
Intubação Intratraqueal/métodos
Masculino
Período Pós-Operatório
Propofol/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Androstanols); 0 (Anesthetics, Inhalation); 0 (Anesthetics, Intravenous); 0 (Methyl Ethers); 0 (Neuromuscular Nondepolarizing Agents); 38LVP0K73A (sevoflurane); UF599785JZ (Fentanyl); WRE554RFEZ (rocuronium); YI7VU623SF (Propofol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171002
[St] Status:MEDLINE


  3 / 2408 MEDLINE  
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[PMID]:28953616
[Au] Autor:Geng W; Nie Y; Huang S
[Ad] Endereço:Department of Anesthesia, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
[Ti] Título:Effects of methylprednisolone on the duration of rocuronium-induced neuromuscular block: A randomized double-blind trial.
[So] Source:Medicine (Baltimore);96(39):e7947, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We aim to investigate whether intraoperative use of methylprednisolone could affect the duration of rocuronium-induced neuromuscular blockade. METHODS: A double blind, randomized, placebo-controlled trial was conducted. A total of 136 patients underwent gynecologic laparoscopic surgery were randomly divided into 3 groups: pregroup, receiving intravenous injection of methylprednisolone (40 mg) 30 minutes before induction of anesthesia; postgroup, receiving intravenous injection of methylprednisolone (40 mg) immediately after induction of anesthesia and intubation; and control group, receiving intravenous injection of normal saline. Patients were intravenously administrated with rocuronium 0.6 mg/kg, and changes in adductor policies evoked twitch responses were measured by ulnar nerve stimulator. RESULTS: We found that all patients achieved maximum blockade effects, and there was no difference in onset time among the 2 groups. For time required to achieve train-of-four ratio (TOFR) 90%, pregroup (64.50 ±â€Š10.52 minutes) and postgroup (65.29 ±â€Š11.64 minutes) were significantly shorter than that of the control group (71.04 ±â€Š10.55 minutes, P = .027), whereas clinical duration and total duration were significantly shorter in the 2 groups received methylprednisolone than the control group. However, there was no significant difference between the 2 treatment groups either in clinical duration and total duration of muscle relaxants, or time required to achieve TOFR 90%. No significant difference was found in recovery index among the 3 groups. CONCLUSION: Our findings suggest that a single intravenous injection of methylprednisolone, no matter preoperatively or intraoperatively, could shorten the duration of rocuronium-induced neuromuscular blockade.
[Mh] Termos MeSH primário: Androstanóis/farmacologia
Glucocorticoides/farmacologia
Procedimentos Cirúrgicos em Ginecologia
Metilprednisolona/farmacologia
Bloqueio Neuromuscular
Fármacos Neuromusculares não Despolarizantes/farmacologia
[Mh] Termos MeSH secundário: Adulto
Método Duplo-Cego
Interações Medicamentosas
Feminino
Glucocorticoides/administração & dosagem
Seres Humanos
Injeções Intravenosas
Metilprednisolona/administração & dosagem
Monitoração Neuromuscular
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Androstanols); 0 (Glucocorticoids); 0 (Neuromuscular Nondepolarizing Agents); WRE554RFEZ (rocuronium); X4W7ZR7023 (Methylprednisolone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007947


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[PMID]:28806470
[Au] Autor:Hristovska AM; Duch P; Allingstrup M; Afshari A
[Ad] Endereço:Juliane Marie Centre - Anaesthesia and Surgical Clinic Department 4013, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, Denmark, 2100.
[Ti] Título:Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults.
[So] Source:Cochrane Database Syst Rev;8:CD012763, 2017 Aug 14.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Acetylcholinesterase inhibitors, such as neostigmine, have traditionally been used for reversal of non-depolarizing neuromuscular blocking agents. However, these drugs have significant limitations, such as indirect mechanisms of reversal, limited and unpredictable efficacy, and undesirable autonomic responses. Sugammadex is a selective relaxant-binding agent specifically developed for rapid reversal of non-depolarizing neuromuscular blockade induced by rocuronium. Its potential clinical benefits include fast and predictable reversal of any degree of block, increased patient safety, reduced incidence of residual block on recovery, and more efficient use of healthcare resources. OBJECTIVES: The main objective of this review was to compare the efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade caused by non-depolarizing neuromuscular agents in adults. SEARCH METHODS: We searched the following databases on 2 May 2016: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (WebSPIRS Ovid SP), Embase (WebSPIRS Ovid SP), and the clinical trials registries www.controlled-trials.com, clinicaltrials.gov, and www.centerwatch.com. We re-ran the search on 10 May 2017. SELECTION CRITERIA: We included randomized controlled trials (RCTs) irrespective of publication status, date of publication, blinding status, outcomes published, or language. We included adults, classified as American Society of Anesthesiologists (ASA) I to IV, who received non-depolarizing neuromuscular blocking agents for an elective in-patient or day-case surgical procedure. We included all trials comparing sugammadex versus neostigmine that reported recovery times or adverse events. We included any dose of sugammadex and neostigmine and any time point of study drug administration. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts to identify trials for eligibility, examined articles for eligibility, abstracted data, assessed the articles, and excluded obviously irrelevant reports. We resolved disagreements by discussion between review authors and further disagreements through consultation with the last review author. We assessed risk of bias in 10 methodological domains using the Cochrane risk of bias tool and examined risk of random error through trial sequential analysis. We used the principles of the GRADE approach to prepare an overall assessment of the quality of evidence. For our primary outcomes (recovery times to train-of-four ratio (TOFR) > 0.9), we presented data as mean differences (MDs) with 95 % confidence intervals (CIs), and for our secondary outcomes (risk of adverse events and risk of serious adverse events), we calculated risk ratios (RRs) with CIs. MAIN RESULTS: We included 41 studies (4206 participants) in this updated review, 38 of which were new studies. Twelve trials were eligible for meta-analysis of primary outcomes (n = 949), 28 trials were eligible for meta-analysis of secondary outcomes (n = 2298), and 10 trials (n = 1647) were ineligible for meta-analysis.We compared sugammadex 2 mg/kg and neostigmine 0.05 mg/kg for reversal of rocuronium-induced moderate neuromuscular blockade (NMB). Sugammadex 2 mg/kg was 10.22 minutes (6.6 times) faster then neostigmine 0.05 mg/kg (1.96 vs 12.87 minutes) in reversing NMB from the second twitch (T2) to TOFR > 0.9 (MD 10.22 minutes, 95% CI 8.48 to 11.96; I = 84%; 10 studies, n = 835; GRADE: moderate quality).We compared sugammadex 4 mg/kg and neostigmine 0.07 mg/kg for reversal of rocuronium-induced deep NMB. Sugammadex 4 mg/kg was 45.78 minutes (16.8 times) faster then neostigmine 0.07 mg/kg (2.9 vs 48.8 minutes) in reversing NMB from post-tetanic count (PTC) 1 to 5 to TOFR > 0.9 (MD 45.78 minutes, 95% CI 39.41 to 52.15; I = 0%; two studies, n = 114; GRADE: low quality).For our secondary outcomes, we compared sugammadex, any dose, and neostigmine, any dose, looking at risk of adverse and serious adverse events. We found significantly fewer composite adverse events in the sugammadex group compared with the neostigmine group (RR 0.60, 95% CI 0.49 to 0.74; I = 40%; 28 studies, n = 2298; GRADE: moderate quality). Risk of adverse events was 28% in the neostigmine group and 16% in the sugammadex group, resulting in a number needed to treat for an additional beneficial outcome (NNTB) of 8. When looking at specific adverse events, we noted significantly less risk of bradycardia (RR 0.16, 95% CI 0.07 to 0.34; I = 0%; 11 studies, n = 1218; NNTB 14; GRADE: moderate quality), postoperative nausea and vomiting (PONV) (RR 0.52, 95% CI 0.28 to 0.97; I = 0%; six studies, n = 389; NNTB 16; GRADE: low quality) and overall signs of postoperative residual paralysis (RR 0.40, 95% CI 0.28 to 0.57; I = 0%; 15 studies, n = 1474; NNTB 13; GRADE: moderate quality) in the sugammadex group when compared with the neostigmine group. Finally, we found no significant differences between sugammadex and neostigmine regarding risk of serious adverse events (RR 0.54, 95% CI 0.13 to 2.25; I = 0%; 10 studies, n = 959; GRADE: low quality).Application of trial sequential analysis (TSA) indicates superiority of sugammadex for outcomes such as recovery time from T2 to TOFR > 0.9, adverse events, and overall signs of postoperative residual paralysis. AUTHORS' CONCLUSIONS: Review results suggest that in comparison with neostigmine, sugammadex can more rapidly reverse rocuronium-induced neuromuscular block regardless of the depth of the block. Sugammadex 2 mg/kg is 10.22 minutes (˜ 6.6 times) faster in reversing moderate neuromuscular blockade (T2) than neostigmine 0.05 mg/kg (GRADE: moderate quality), and sugammadex 4 mg/kg is 45.78 minutes (˜ 16.8 times) faster in reversing deep neuromuscular blockade (PTC 1 to 5) than neostigmine 0.07 mg/kg (GRADE: low quality). With an NNTB of 8 to avoid an adverse event, sugammadex appears to have a better safety profile than neostigmine. Patients receiving sugammadex had 40% fewer adverse events compared with those given neostigmine. Specifically, risks of bradycardia (RR 0.16, NNTB 14; GRADE: moderate quality), PONV (RR 0.52, NNTB 16; GRADE: low quality), and overall signs of postoperative residual paralysis (RR 0.40, NNTB 13; GRADE: moderate quality) were reduced. Both sugammadex and neostigmine were associated with serious adverse events in less than 1% of patients, and data showed no differences in risk of serious adverse events between groups (RR 0.54; GRADE: low quality).
[Mh] Termos MeSH primário: Inibidores da Colinesterase/farmacologia
Neostigmina/farmacologia
Bloqueio Neuromuscular
Fármacos Neuromusculares não Despolarizantes/antagonistas & inibidores
gama-Ciclodextrinas/farmacologia
[Mh] Termos MeSH secundário: Adulto
Androstanóis/antagonistas & inibidores
Atracúrio/análogos & derivados
Atracúrio/antagonistas & inibidores
Inibidores da Colinesterase/administração & dosagem
Inibidores da Colinesterase/efeitos adversos
Seres Humanos
Neostigmina/administração & dosagem
Neostigmina/efeitos adversos
Ensaios Clínicos Controlados Aleatórios como Assunto
Fatores de Tempo
Brometo de Vecurônio/antagonistas & inibidores
gama-Ciclodextrinas/administração & dosagem
gama-Ciclodextrinas/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Androstanols); 0 (Cholinesterase Inhibitors); 0 (Neuromuscular Nondepolarizing Agents); 0 (gamma-Cyclodextrins); 2GQ1IRY63P (Atracurium); 361LPM2T56 (Sugammadex); 3982TWQ96G (Neostigmine); 7E4PHP5N1D (Vecuronium Bromide); QX62KLI41N (cisatracurium); WRE554RFEZ (rocuronium)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012763


  5 / 2408 MEDLINE  
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[PMID]:28739730
[Au] Autor:Jiang A; Zhao H; Liu X; Yu M; Chen J; Jiang WG
[Ad] Endereço:Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, P.R. China.
[Ti] Título:Comparison of Different Muscle-Relaxant Anesthetics on Growth, Migration and Invasion of Gastric Cancer Cells.
[So] Source:Anticancer Res;37(8):4371-4378, 2017 08.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIM: Muscle relaxants, also known as neuromuscular blocking agents, can block nerve impulses to the muscles and are always used in surgery for general anesthesia. However, the effect of muscle-relaxant anesthetics on cell activity in gastric cancer is currently unknown. The present study aimed to examine and compare the role of three different muscle-relaxant anesthetics in gastric cancer cells. MATERIALS AND METHODS: Gastric cancer cells (SGC7901 and BGC 823) were treated with a different dose of muscle-relaxant anesthetics, Rocuronium bromide (Rb), Vecuronium bromide (Vb) and Cisatracurium Besilate (CB). Using in vitro models, the effects on gastric cancer cell invasion, growth and migration of various anesthetics were subsequently investigated. RESULTS: We found that Rb increased the growth, invasion and migration of gastric cancer cells SGC7901 and BGC823. However, Vb and CB, as relatively mitigative anesthetics, did not significantly affect gastric cancer cell malignant phenotype at their regular blood concentration. CONCLUSION: Our results are important in selecting the type and dose of anesthetic used for surgery of gastric cancer patients. An understanding of the effect of muscle-relaxant anesthetics and their impact on tumor metastasis is critical, since it provides insight into the appropriate anesthetic strategy that could improve long-term survival in some patients with gastric cancer.
[Mh] Termos MeSH primário: Androstanóis/efeitos adversos
Atracúrio/análogos & derivados
Bloqueadores Neuromusculares/efeitos adversos
Neoplasias Gástricas/patologia
Brometo de Vecurônio/efeitos adversos
[Mh] Termos MeSH secundário: Androstanóis/farmacologia
Atracúrio/efeitos adversos
Atracúrio/farmacologia
Adesão Celular/efeitos dos fármacos
Linhagem Celular Tumoral
Movimento Celular/efeitos dos fármacos
Proliferação Celular/efeitos dos fármacos
Relação Dose-Resposta a Droga
Seres Humanos
Invasividade Neoplásica
Bloqueadores Neuromusculares/farmacologia
Brometo de Vecurônio/farmacologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Androstanols); 0 (Neuromuscular Blocking Agents); 2GQ1IRY63P (Atracurium); 7E4PHP5N1D (Vecuronium Bromide); QX62KLI41N (cisatracurium); WRE554RFEZ (rocuronium)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE


  6 / 2408 MEDLINE  
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Braga, Angélica de Fátima de Assunçäo
Braga, Franklin Sarmento da Silva
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[PMID]:28658142
[Au] Autor:Santos FNC; Braga AFA; Junqueira FEF; Bezerra RM; Almeida FF; Braga FSDS; Carvalho VH
[Ad] Endereço:aDepartment of Anesthesiology bDepartment of Pharmacology, State University of Campinas, Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil - CEP 13083-887.
[Ti] Título:Use of neuromuscular blockers and neostigmine for general anesthesia and its association with neuraxial blockade: A retrospective study.
[So] Source:Medicine (Baltimore);96(26):e7322, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This research aimed to assess the use of neuromuscular blockers (NMB) and its reversal, associated or not with neuraxial blockade, after general anesthesia.This retrospective study analyzed 1295 patients that underwent surgery with general anesthesia at Prof. Dr. José Aristodemo Pinotti Hospital in 2013. The study included patients aged >1 year, with complete, readable medical charts and anesthetic records.Rocuronium (ROC) was the most used NMB (96.7%), with an initial dose of 0.60 (0.52-0.74) mg/kg and total dose of 0.38 (0.27-0.53) mg/kg/h. In 24.3% of the cases, neuraxial blockade was associated with a significantly longer anesthesia (P < .001) than in cases without neuraxial block, regardless of technique (total intravenous (TIV) vs intravenous and inhalational (IV+IN)). In 71.9% of the cases, a single dose of NMB was used. Patients under TIV general anesthesia associated with neuraxial blockade had a lower total dose of ROC (mg/kg/h) in comparison with TIV GA alone (0.30 (0.23-0.39) and 0.42 (0.30-0.56) mg/kg/h, respectively, P < .001). The same was observed for patients under IV+IN GA (0.32 (0.23-0.41) and 0.43 (0.31-0.56) mg/kg/h, respectively, P < .001). The duration of anesthesia was longer according to increasing number of additional NMB doses (P < .001). Dose of neostigmine was 2.00 (2.00-2.00) mg or 29.41 (25.31-33.89) µg/kg. The interval between neostigmine and extubation was >30 minutes in 10.9% of cases.The most widely used NMB was ROC. Neuroaxial blockade (spinal or epidural) was significantly associated with reduced total dose of ROC (mg/kg/h) during general anesthesia, even in the absence of neuromuscular monitoring and regardless of general anesthetic technique chosen. In most cases, neostigmine was used to reverse neuromuscular block. The prolonged interval between neostigmine and extubation (>30 minutes) was neither associated with total doses of ROC or neostigmine, nor with the time of NMB administration. This study corroborates the important role of quantitative neuromuscular monitors and demonstrates that neuraxial blockade is associated with reduced total ROC dose. Further studies are needed to evaluate the possible role of neuraxial blockade in reducing the incidence of postoperative residual curarization.
[Mh] Termos MeSH primário: Anestesia Geral
Neostigmina/uso terapêutico
Bloqueio Nervoso
Bloqueadores Neuromusculares/uso terapêutico
Parassimpatomiméticos/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Androstanóis/uso terapêutico
Feminino
Seres Humanos
Meia-Idade
Estudos Retrospectivos
Centros de Atenção Terciária
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Androstanols); 0 (Neuromuscular Blocking Agents); 0 (Parasympathomimetics); 3982TWQ96G (Neostigmine); WRE554RFEZ (rocuronium)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007322


  7 / 2408 MEDLINE  
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[PMID]:28658119
[Au] Autor:Koo BW; Jung KW; Oh AY; Kim EY; Na HS; Choi ES; Seo KS
[Ad] Endereço:aDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam bDepartment of Surgery, Jeju National University Hospital, Jeju cDepartment of Anesthesiology and Pain Medicine, Seoul National University School of Medicine dDepartment of Anesthesiology and Pain Medicine, Nowon Eulji Medical Center, Eulji University eDepartment of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea.
[Ti] Título:Is neuromuscular blocker needed in children undergoing inguinal herniorrhaphy?: A prospective, randomized, and controlled trial.
[So] Source:Medicine (Baltimore);96(26):e7259, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Intraoperative neuromuscular blocker is widely used, but is known to be associated with postoperative residual paralysis, which is known to be associated with increased risk of pulmonary complications. Hence, its use should be individualized and restricted to procedures where it is mandatory. We examined whether not using a neuromuscular blocker affects the surgical conditions in children undergoing inguinal herniorrhaphy. METHODS: Anesthesia was induced and maintained with sevoflurane in 60% nitrous oxide, and the airway was maintained using an I-gel. In total, 66 children aged 1 to 6 years were randomized to receive rocuronium (rocuronium group, n = 33) or saline (control group, n = 33); 61 children of them finished the study. A single surgeon who performed the operation rated the surgical condition of each patient on a 4-point scale (1 = poor, 2 = acceptable, 3 = good, and 4 = excellent). Intraoperative patient movement, recovery time, emergence agitation, and postoperative pain scores were evaluated. RESULTS: One patient in control group and no patient in rocuronium group showed intraoperative movement. When noninferiority test was done for intraoperative patient movement, with the noninferiority margin of 20%, the difference of absolute risk was 3.3% (95% confidence interval -8.0% to 16.7%) and saline group was noninferior to rocuronium group. All of the patients showed good to excellent surgical conditions, and no difference was found between the 2 groups. The recovery time was shorter in the control group than in the rocuronium group (4.5 ±â€Š1.8 vs 5.6 ±â€Š2.2 minutes, respectively; P = .028). CONCLUSION: In children aged 1 to 6 years undergoing inguinal herniorhaphy under sevoflurane anesthesia using an I-gel, not using neuromuscular blocker showed similar intraoperative condition and shortened recovery time compared with using neuromouscular blocker.
[Mh] Termos MeSH primário: Androstanóis/uso terapêutico
Hérnia Inguinal/cirurgia
Herniorrafia
Bloqueadores Neuromusculares/uso terapêutico
[Mh] Termos MeSH secundário: Androstanóis/efeitos adversos
Anestésicos Inalatórios/uso terapêutico
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Masculino
Éteres Metílicos/uso terapêutico
Movimento/efeitos dos fármacos
Bloqueio Neuromuscular/efeitos adversos
Bloqueadores Neuromusculares/efeitos adversos
Dor Pós-Operatória
Recuperação de Função Fisiológica/efeitos dos fármacos
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Androstanols); 0 (Anesthetics, Inhalation); 0 (Methyl Ethers); 0 (Neuromuscular Blocking Agents); 38LVP0K73A (sevoflurane); WRE554RFEZ (rocuronium)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007259


  8 / 2408 MEDLINE  
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[PMID]:28617033
[Au] Autor:Wang Z; Wang H; Hu P; Jiang J; Zhao Q
[Ad] Endereço:Phase I Unit, Clinical Pharmacology Research Center, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100032, China.
[Ti] Título:A UPLC-MS/MS method for quantification of 5α-androst-3ß,5,6ß-triol in human plasma: development, validation and its application in clinical pharmacokinetic study.
[So] Source:Bioanalysis;9(11):873-885, 2017 Jun.
[Is] ISSN:1757-6199
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: 5α-androst-3ß,5,6ß-triol is a novel ischemic stroke drug under clinical development. The objective of this study was to develop and validate a simple ultraperformance liquid chromatography tandem mass spectrometry method for 5α-androst-3ß,5,6ß-triol in human plasma and its application in clinical pharmacokinetic study. Methodology & results: After being pretreated using an automatized solid-phase extraction procedure, plasma sample was separated on a Waters Acquity™ BEH C column (2.1 × 50 mm id, 1.7 mm) by an Acquity UPLC system and detected by an API 5500 triple quadrupole mass spectrometer, which was validated following international guidelines. CONCLUSION: A simple method was successfully validated over a concentration range of 2.00-500 ng/ml for 5α-androst-3ß,5,6ß-triol and applied to investigate its plasma pharmacokinetic profiles in healthy Chinese subjects.
[Mh] Termos MeSH primário: Androstanóis/sangue
Cromatografia Líquida de Alta Pressão/métodos
Espectrometria de Massas em Tandem/métodos
[Mh] Termos MeSH secundário: Seres Humanos
Limite de Detecção
Reprodutibilidade dos Testes
Extração em Fase Sólida/métodos
Espectrometria de Massas por Ionização por Electrospray/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Androstanols); 0 (androst-3,5,6-triol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE
[do] DOI:10.4155/bio-2017-0035


  9 / 2408 MEDLINE  
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[PMID]:28591053
[Au] Autor:Yoo JH; Kim SI; Park SY; Jun MR; Kim YE; Kim HJ
[Ad] Endereço:Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
[Ti] Título:Use of sugammadex in a patient with progressive muscular atrophy and in a patient with amyotrophic lateral sclerosis: Case report.
[So] Source:Medicine (Baltimore);96(23):e7098, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: We herein present 2 cases involving the combination of rocuronium and sugammadex in patients with motor neuron disease. The patients were a 54-year-old man with progressive muscular atrophy who underwent removal of internal fixators in the arm and leg, and a 66-year-old woman with amyotrophic lateral sclerosis who underwent skin grafting in the left lower leg. General anesthesia was induced with propofol, rocuronium, and remifentanil and maintained with desflurane and remifentanil. At the end of the surgical procedure, we administered sugammadex. Three or 4 minutes after administration of sugammadex, the patients began to breathe spontaneously and were extubated without complications. CONCLUSION: Sugammadex can be used successfully to reverse neuromuscular blockade in patients with motor neuron disease.
[Mh] Termos MeSH primário: Esclerose Amiotrófica Lateral/tratamento farmacológico
Esclerose Amiotrófica Lateral/cirurgia
Atrofia Muscular Espinal/tratamento farmacológico
Atrofia Muscular Espinal/cirurgia
Fármacos Neuromusculares/uso terapêutico
gama-Ciclodextrinas/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Androstanóis/uso terapêutico
Período de Recuperação da Anestesia
Feminino
Seres Humanos
Masculino
Meia-Idade
Bloqueio Neuromuscular
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Androstanols); 0 (Neuromuscular Agents); 0 (gamma-Cyclodextrins); 361LPM2T56 (Sugammadex); WRE554RFEZ (rocuronium)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170706
[Lr] Data última revisão:
170706
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007098


  10 / 2408 MEDLINE  
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[PMID]:28399799
[Au] Autor:Aouad MT; Alfahel WS; Kaddoum RN; Siddik-Sayyid SM
[Ad] Endereço:Department of Anaesthesiology, American University of Beirut Medical Center, P.O. Box 11-0236, Beirut, Lebanon. ss01@aub.edu.lb.
[Ti] Título:Half dose sugammadex combined with neostigmine is non-inferior to full dose sugammadex for reversal of rocuronium-induced deep neuromuscular blockade: a cost-saving strategy.
[So] Source:BMC Anesthesiol;17(1):57, 2017 Apr 11.
[Is] ISSN:1471-2253
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sugammadex reverses the effect of rocuronium more rapidly and effectively than neostigmine, at all levels of neuromuscular blockade (NMB). However, its cost is prohibitive. The combination of half dose sugammadex with neostigmine would be non-inferior to full dose sugammadex for the reversal of deep NMB. This approach would reduce the cost of sugammadex while preserving its efficacy. METHODS: Patients were randomly allocated to receive sugammadex 4 mg/kg (Group S) or sugammadex 2 mg/kg with neostigmine 50 µg/kg and glycopyrrolate 10 µg/kg (Group NS) for reversal of rocuronium deep NMB. The primary outcome was the percentage of patients who recovered to 90% Train of Four (TOF) ratio within 5 min. The non-inferiority margin was set at 10%. RESULTS: Twenty eight patients were enrolled in each group. The number of patients who reached 90% TOF ratio within 5 min was 27 out of 28 (96%) in group S versus 25 out of 28 (89%) in group NS by intention-to-treat (difference: 7%, 95% CI of the difference: -9% to 24%). The number of patients who reached 90% TOF ratio within 5 min was 26 out of 26 (100%) in group S versus 23 out of 25 (92%) in group NS by per-protocol (difference: 8%, 95% CI of the difference: -6% to 25%). CONCLUSIONS: Sugammadex 2 mg/kg with neostigmine 50 µg/kg was at worst 9% and 6% less effective than sugammadex 4 mg/kg by intention-to-treat and by per-protocol analysis respectively. Hence, the combination is non-inferior to the recommended dose of sugammadex. TRIAL REGISTRATION: Clinicaltrials.gov NCT 02375217 , registered on February 11, 2015.
[Mh] Termos MeSH primário: Androstanóis/antagonistas & inibidores
Neostigmina/farmacologia
Bloqueio Neuromuscular/métodos
gama-Ciclodextrinas/farmacologia
[Mh] Termos MeSH secundário: Adulto
Androstanóis/farmacologia
Inibidores da Colinesterase/farmacologia
Análise Custo-Benefício
Relação Dose-Resposta a Droga
Interações Medicamentosas
Feminino
Seres Humanos
Masculino
Fármacos Neuromusculares não Despolarizantes/antagonistas & inibidores
Fármacos Neuromusculares não Despolarizantes/farmacologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Androstanols); 0 (Cholinesterase Inhibitors); 0 (Neuromuscular Nondepolarizing Agents); 0 (gamma-Cyclodextrins); 361LPM2T56 (Sugammadex); 3982TWQ96G (Neostigmine); WRE554RFEZ (rocuronium)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1186/s12871-017-0348-9



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