scholarly journals Comparing Sugammadex in the Adult and Geriatric Population

2020 ◽  
Author(s):  
Jason Medeiros
Keyword(s):  
Neuromuscular Blockade ◽  
Adverse Outcomes ◽  
Geriatric Population ◽  
Residual Neuromuscular Blockade ◽  
Neuromuscular Blockade Reversal

A comparison of using sugammadex for neuromuscular blockade reversal in adult and geriatric populations, examining time to recovery and adverse outcomes related to residual neuromuscular blockade.

scholarly journals Impaired Upper Airway Integrity by Residual Meeting Abstracts

2009 ◽  
Vol 110 (6) ◽  
pp. 1253-1260 ◽  
Author(s):  
Frank Herbstreit ◽  
Jürgen Peters ◽  
Matthias Eikermann
Keyword(s):  
Neuromuscular Blockade ◽  
Lung Volume ◽  
Upper Airway ◽  
Random Order ◽  
Compensatory Response ◽  
Residual Neuromuscular Blockade ◽  
Pharyngeal Pressure ◽  
Pressure Threshold ◽  
Airway Collapsibility ◽  
Closing Pressure

Background Residual neuromuscular blockade increases the risk to develop postoperative complications. The authors hypothesized that minimal neuromuscular blockade (train-of-four [TOF] ratio 0.5-1) increases upper airway collapsibility and impairs upper airway dilator muscle compensatory responses to negative pharyngeal pressure challenges. Methods Epiglottic and nasal mask pressures, genioglossus electromyogram, respiratory timing, and changes in lung volume were measured in awake healthy volunteers (n = 15) before, during (TOF = 0.5 and 0.8 [steady state]), and after recovery of TOF to unity from rocuronium-induced partial neuromuscular blockade. Passive upper airway closing pressure (negative pressure drops, random order, range +2 to -30 cm H2O) and pressure threshold for flow limitation were determined. Results Upper airway closing pressure increased (was less negative) significantly from baseline by 54 +/- 4.4% (means +/- SEM), 37 +/- 4.2%, and 16 +/- 4.1% at TOF ratios of 0.5, 0.8, and 1.0, respectively (P < 0.01 vs. baseline for any level). Phasic genioglossus activity almost quadrupled in response to negative (-20 cm H2O) pharyngeal pressure at baseline, and this increase was significantly impaired by 57 +/- 44% and 32 +/- 6% at TOF ratios of 0.5 and 0.8, respectively (P < 0.01 vs. baseline). End-expiratory lung volume, respiratory rate, and tidal volume did not change. Conclusion Minimal neuromuscular blockade markedly increases upper airway closing pressure, partly by impairing the genioglossus muscle compensatory response. Increased airway collapsibility despite unaffected values for resting ventilation may predispose patients to postoperative respiratory complications, particularly during airway challenges.

scholarly journals Ankle Fracture Complications in the Elderly

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0038
Author(s):  
Andrew Polk ◽  
Brian Buck ◽  
Michael Robertson ◽  
James Cook ◽  
Courtney Felton
Keyword(s):  
Geriatric Patient ◽  
Patient Population ◽  
Age Groups ◽  
Adverse Outcomes ◽  
Ankle Fractures ◽  
Complication Rates ◽  
Geriatric Population ◽  
Fracture Dislocations ◽  
Operative Fixation ◽  
Time From Injury

Category: Trauma Introduction/Purpose: In the geriatric patient population, pre-existing medical conditions and poor bone quality often make operative fixation of unstable ankle fractures and fracture-dislocations more challenging. The objective of this study was to characterize the complications that occurred following operative fixation of these injuries at our institution and to determine whether complication rates were higher in our geriatric patient population (65 years and older) as compared to our younger patient population. We hypothesized that complication rates in the geriatric population would be significantly higher relative to complication rates in the younger population. We also hypothesized that in elderly patients, the soft tissue envelope would be less forgiving and require significantly more time for swelling to decrease to a level considered appropriate for definitive surgical fixation to occur. Methods: With IRB approval, a review of medical records for patients diagnosed with ankle fractures or fracture-dislocations and operated on between January of 2015 and December of 2016 was performed. Major complications were defined as any adverse outcomes requiring further surgical intervention such as irrigation and debridement for infection or exposed hardware, nonunion, major hardware failure, or amputation. Minor complications included other adverse outcomes which did not require further surgical intervention such as wound dehiscence, loss of reduction, or delayed union. Data were compared for statistically significant (p<0.05) differences. Results: Medical record review produced 110 patients meeting criteria for inclusion with a mean follow-up of 179 days (range, 0 to 601 days). No significant (p>0.08) differences were noted in rates of major, minor, or total complications between geriatric and younger patients treated at our institution (Fig. 1). An analysis of patient characteristics, demonstrated a significantly (p=0.035) higher proportion of trimalleolar ankle fractures within the geriatric population, but the proportions of other injury types were not significantly (p>0.198) different between age groups. Prevalence of tobacco use, alcohol use, illicit drug use, or diabetes mellitus was not found to be significantly different (p>0.058) between age groups. No significant (p=0.12) difference was found in time from injury to definitive surgical treatment between age groups. Conclusion: Complication rates following operative treatment of ankle fractures and fracture-dislocations were not significantly higher in our geriatric patient population, although the incidence of minor complications in the geriatric population was markedly increased relative to the younger population. A lack of significant difference in time from injury to definitive surgical treatment between age groups suggests that geriatric patients may not require a prolonged time for soft tissue swelling to decrease prior to surgery. Further study with a larger sample size is needed to determine if these findings are clinically significant.

THE RATE OF RESIDUAL NEUROMUSCULAR BLOCKADE AFTER LAPAROSCOPIC APPENDECTOMY SURGERY AT NGUYEN TRI PHUONG HOSPITAL

2021 ◽  
Vol 62 (6) ◽  
Author(s):  
Doan Minh Nhut ◽  
Nguyen Van Chinh
Keyword(s):  
Neuromuscular Blockade ◽  
Laparoscopic Appendectomy ◽  
Muscle Relaxant ◽  
Muscle Relaxation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Residual Rate ◽  
Residual Neuromuscular Blockade ◽  
Study Results

Introduction: In Vietnam, using a muscle accelerator to measure the TOF index to monitor residue neuromuscular blockade has not been performed routinely, extubation is mainly based on subjective clinical assessments. Methods: A cross-sectional study on 96 patients undergoing laparoscopic appendectomy at Nguyen Tri Phuong Hospital, from November 2020 to May 2021. Objectives: The study was conducted with 2 objectives including (1) Determine the progression of TOF index at 7 time points: immediately after arriving in the recovery room, after extubation, 15 minutes, 30 minutes, 60 minutes, 90 minutes, 120 minutes after extubation; (2) Determination of residual muscle relaxant rate of patients undergoing laparoscopic appendectomy at Nguyen Tri Phuong Hospital. Results: The average TOF ≥ 0,9 index after laparoscopic appendectomy at the time of resuscitation was 88.11%, extubation was 90.53% and at 120 minutes after extubation. is 99.88%. Residual muscle relaxation after surgery when TOF index < 0.9. At the time of resuscitation, the highest residual rate of muscle relaxant accounted for 58.33%, followed by the time of extubation 39.58%, 15 minutes after extubation was 21.88%. Until 120 after extubation, there is no case that has residue neuromuscular blockade. Conclusion: Through the study results, it is necessary to monitor patients undergoing laparoscopic appendectomy with quantitative devices to more accurately assess the clinical index of muscle relaxation.

scholarly journals PSU18 BUDGET IMPACT ANALYSIS OF SUGAMMADEX ON NEUROMUSCULAR BLOCKADE REVERSAL IN COLOMBIA

2019 ◽  
Vol 22 ◽  
pp. S368
Author(s):  
P. Lasalvia ◽  
D. Rosselli ◽  
F. Hernández ◽  
C. Beltran ◽  
M. Rojas ◽  
...  
Keyword(s):  
Neuromuscular Blockade ◽  
Impact Analysis ◽  
Budget Impact ◽  
Budget Impact Analysis ◽  
Neuromuscular Blockade Reversal
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