Neuromuscular Blocking Drugs: Discovery and Development

Raghavendra, Thandla

doi:10.1177/014107680209500713

Cited by 54 publications

(40 citation statements)

References 33 publications

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“…Rocuronium is a nondepolarizing blocking agent (NMBA), intermediate acting (60-120 seconds), with relative long effects (40-90 minutes), and with the possibility of effect reversal (agents-Sugammadex) (Raghavendra, 2002). For this moment there are limited studies in veterinary medicine regarding the use of this agent in balanced anaesthesia (Stevens, 1997;Brauer, 2011; Duke-Navakoski, 2012), but the safety is proven by studies from human medicine (Khalil, 1994;Mirakhur, 1994;Robertson, 2005;Craig, 2009) …”

Section: Introductionmentioning

confidence: 99%

Rocuronium Use in Anaesthetics Protocol in Canine Patients with Orthopedic Disease

Popovici¹,

Mircean²,

Scurtu³

et al. 2014

BUASVMCN-VM

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In modern veterinary medicine, like in human medicine all major surgery procedures must be performed under balanced anaesthesia. This protocol contained substances that insure: neurovegetativ protection, analgesia, miorelaxation, hypnosis. Rocuronium represent a nondepolarizing agent, intermediate acting ( 60-120 seconds), with relative long effects ( 40-90 minutes), and with the posibility of effect reversal ( agents-Sugammadex). The aim of this study was monitorization of clinical, haematological and biochemical parameters perioperative in dogs scheduled for orthopedic procedures. This study was performed on ive canine patients (different breed, with age between 4 months to 11 years), scheduled for femoral had resection procedure. In this dogs balanced anaesthesia was performed: induction with propofol to effect, maintained with sevo lurane 2.5%; analgesic component: fentanyl 3μg/kg b.w.-bolus followed by CRI 5 μg/kg b.w./min, the neuromuscular blocking agent was represented by rocuronium 0.4 mg/kg b.w. Haematological analysis were performed with Abacus Junior Vet 3 diff analyzer, biochemical parameters with UV-VIS Screen Master Touch Hospitex Diagnostic spectrophotometer, and electrolytes with GEM Premier 2000 analyzer. The majority of biochemical and mineral parameters suffered only small changes, without statistical importance. After the surgery we determined only a slight reduction of erythrocyte number, haemoglobin and PCV, a mild increase of γ-globulin. Regarding the clinical parameters only internal temperatures was modi ied. We recommend the use of rocuronium in orthopedic procedures for the advantages offered in the surgical act (profound miorelaxation) without any major biochemical, haematological, electrolytes alteration.

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Section: Introductionmentioning

confidence: 99%

Rocuronium Use in Anaesthetics Protocol in Canine Patients with Orthopedic Disease

Popovici¹,

Mircean²,

Scurtu³

et al. 2014

BUASVMCN-VM

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“… The introduction of neuromuscular blocking agents, first used in adult anesthesia in 1942 (13), allowed intubation of children in a lighter plane of anesthesia making laryngoscopy a smoother and safer procedure. Until this time the deeper planes of anesthesia required to prevent laryngospasm during intubation ran the inevitable risk of cardio‐respiratory compromise.…”

Section: An Historical Perspectivementioning

confidence: 99%

Pediatric laryngoscopes and intubation aids old and new

Doherty¹,

Froom

Gildersleve

2009

Pediatric Anesthesia

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SummaryThis review summarizes the evolution of the pediatric laryngoscope using some of the established landmarks in the history of anesthesia. Children were rarely intubated before 1940 though the subsequent 30 years saw a proliferation of pediatric laryngoscopes in part driven by the developments in pediatric anesthesia and surgery, manufacturing techniques and materials and a change in airway management philosophy exemplified by Jackson Rees's argument against the notion that intubation was to be avoided in children. A perspective on the present day describes the modifications to popular straight and curved blade laryngoscopes and the development of new devices that enhance direct visualization of the larynx. There are an everincreasing number of laryngoscope devices that assist in indirect visualization of the larynx such as rigid optical stylets and flexible fiber-optic scopes. Images from many of these devices may be enhanced by digital camera or real-time video technology. The prospect of future laryngoscope development is glimpsed in the arrival of light emitting diode light source technology and questions remain regarding the consequences of equipment disposability and at the fidelity of disposable equipment manufacture.

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“…1 The depolarizing relaxant suxamethonium was first introduced in the early 1950s and was noted to produce rapid profound muscle relaxation within 30 seconds that lasted only a few minutes in the majority of patients. 1 This quick acting, short duration relaxant proved useful for induction of anesthesia by rapid-sequence induction (RSI), where swift placement of an endotracheal tube protects the respiratory tract from gastric content aspiration. Additionally, the short duration of action of suxamethonium gives the anesthetist the option of allowing the patient to recover spontaneous ventilation relatively quickly, should difficulty in securing the airway arise.…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Sugammadex for Neuromuscular Blockade Reversal

Lobaz

Clymer

Sammut

2014

Clinical Medicine Insights: Therapeutics

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AbstrAct:Since its first human use in 2005, the γ-cyclodextrin sugammadex (Org 25969) has had the potential to become the reversal agent of choice, for rocuronium-or vecuronium-induced neuromuscular blockade. Sugammadex binds to the aminosteroid neuromuscular blocker, encapsulating it and extracting it from the neuromuscular junction, effectively ceasing activity and allowing neuromuscular transmission to recover rapidly. Phases I-III and subsequent trials have found sugammadex to be safe and effective in a wide range of doses and for the reversal of a range of depth of muscle relaxation in healthy volunteers and a variety of disease states. Sugammadex use may allow refinement of anesthetic practice and improvement in surgical conditions, through the maintenance of deep neuromuscular blockade right to the end of surgery, with subsequent rapid reversal. Debate remains about the use of sugammadex in the treatment of rocuronium anaphylaxis and airway emergencies. The high price of sugammadex currently prohibits its routine use, but if the price falls, after expiry of its patent, it may become cost-effective as a readily available agent in certain specific clinical situations. Serious adverse reactions have occurred in less than 1% of patients and are most commonly because of hypersensitivity. No deaths have been reported, but caution is advised in neonates, pediatrics, and pregnancy where data are lacking.

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Neuromuscular Blocking Drugs: Discovery and Development

Cited by 54 publications

References 33 publications

Rocuronium Use in Anaesthetics Protocol in Canine Patients with Orthopedic Disease

Rocuronium Use in Anaesthetics Protocol in Canine Patients with Orthopedic Disease

Pediatric laryngoscopes and intubation aids old and new

Safety and Efficacy of Sugammadex for Neuromuscular Blockade Reversal

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