scholarly journals Nondepolarizing neuromuscular blocking drugs and train-of-four fade

1995 ◽  
Vol 42 (3) ◽  
pp. 213-216 ◽  
Author(s):  
Éamon P. McCoy ◽  
Fiona M. Connolly ◽  
Rajinder K. Mirakhur ◽  
Paul B. Loan ◽  
L. Douglas Paxton
2001 ◽  
Vol 95 (1) ◽  
pp. 96-101 ◽  
Author(s):  
Benoît Plaud ◽  
Bertrand Debaene ◽  
François Donati

Background Some studies suggest that the orbicularis oculi is resistant to neuromuscular blocking drugs and behaves like laryngeal muscles. Others report little or no difference between the orbicularis oculi and the adductor pollicis. These discrepancies could be related to the exact site of recording. The purpose of this study was to compare two monitoring sites around the eye with the adductor pollicis and the laryngeal adductor muscles. Methods After institutional approval and informed consent, the evoked response to train-of-four stimulation was measured in 12 patients by acceleromyography at the thumb (adductor pollicis), the eyelid (orbicularis oculi), and the superciliary arch (corrugator supercilii) after 0.5 mg/kg rocuronium during propofol-fentanyl-nitrous oxide anesthesia. In 12 other patients, laryngeal adductor neuromuscular blockade was assessed via the cuff of the tracheal tube and compared with the adductor pollicis and the corrugator supercilii after 0.6 mg/kg rocuronium. Results After 0.5 mg/kg, maximum blockade (%T1, mean +/- SD) was less at the corrugator supercilii (80+/-20%) than at the adductor pollicis (100+/-1%) and the orbicularis oculi (93+/-8%) (P < 0.01). Clinical duration (25%T1) was shorter at the corrugator supercilii (12+/-7 min) than at the adductor pollicis (25+/-4 min) and orbicularis oculi (24+/-10 min) (P < 0.01). After 0.6 mg/kg, maximum blockade was similar at the corrugator supercilii (88+/-8%) and the laryngeal adductor muscles (89+/-11%). Clinical duration at the corrugator supercilii and the laryngeal adductors was 17+/-7 and 17+/-10 min, respectively. Conclusions Muscles around the eye vary in their response to rocuronium. The response of the superciliary arch (corrugator supercilii) reflects blockade of laryngeal adductor muscles. However, the eyelid (orbicularis oculi) and thumb (adductor pollicis) have similar sensitivities.


2018 ◽  
Vol 65 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Stephen Goetz ◽  
Benjamin Pritts ◽  
Bryant Cornelius. DDS

Sugammadex is a novel drug capable of reversing paralysis induced by the common steroidal nondepolarizing neuromuscular blocking drugs, rocuronium and vecuronium. Reversal is complete at any depth of blockade dependent on the dose of sugammadex administered. This allows rocuronium to be used as a rescue agent in scenarios where succinylcholine is contraindicated. Sugammadex is considered a safe drug with minimal side effects compared with traditional reversal with neostigmine and glycopyrrolate. This article features a case report where succinylcholine was undesirable and rapid reversal of paralysis with sugammadex was used during general anesthesia for dentistry.


1985 ◽  
Vol 62 (4) ◽  
pp. 392-395 ◽  
Author(s):  
Mahesh P. Mehta ◽  
Won W. Choi ◽  
Samir D. Gergis ◽  
Martin D. Sokoll ◽  
Andrew J. Adoiphson

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