Neuromuscular monitoring: an update

Duţu, Mădălina; Ivascu, Robert Iulian; Tudorache, Oana; Morlova, Darius; Stanca, A; Negoiță, Silvius; Corneci, Dan

doi:10.21454/rjaic.7518.251.nrm

Cited by 17 publications

(9 citation statements)

References 56 publications

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“…The most important factors for addressing the problems after neuromuscular blockade, such as residual neuromuscular block, recurarization, and consequent pulmonary complications, are monitoring of neuromuscular functions and administration of appropriate antagonists [ 26 ]. In the present survey, 79.3% reported that a neuromuscular monitoring device was available for clinical application at their hospital, which was similar to the rates reported in a 2010 Korean survey (available in operating room [OR]: 83.3%, available in hospital: 79.5%) [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Current use of neuromuscular blocking agents and antagonists in Korea: a 2018 survey

et al. 2019

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Background Neuromuscular blocking agents (NMBAs) and neuromuscular monitoring in anesthetic management are integral for endotracheal intubation, better visualization of the surgical field, and prevention of residual neuromuscular blockade and pulmonary complications. Sugammadex is a drug that reduces risk of residual neuromuscular blockade, with more rapid recovery compared to anticholinesterase. The purpose of this study was to investigate current usage status of NMBAs and antagonist with neuromuscular monitoring, among anesthesiologists in Korea. Methods Anesthesiologists working in Korea were invited to participate in an online survey via email January 2–February 28, 2018. The questionnaire consisted of 45 items, including preferred NMBAs, antagonists, neuromuscular monitoring, and complications related to the use sugammadex. A total of 174 responses were analyzed. Results Rocuronium was a commonly used NMBA for endotracheal intubation (98%) of hospitals, and maintenance of anesthesia (83.3%) in of hospitals. Sugammadex, pyridostigmine, and neostigmine were used in 89.1%, 87.9%, and 45.4% of hospitals. Neuromuscular monitoring was employed in 79.3% of hospitals; however only 39.7% of hospitals used neuromuscular monitoring before antagonist administration. Usual dosage range of sugammadex was 2.1–4 mg/kg in 35.1% of hospitals, within 2 mg/kg in 34.5% of hospitals, and 1 vial regardless of body weight in 22.4% of hospitals. Sugammadexrelated complications were encountered by 14.9% of respondents. Conclusions This survey indicates several minor problems associated with the use of antagonists and neuromuscular monitoring. However, most anesthesiologists appear to have appropriate information regarding the usage of NMBAs and sugammadex.

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Section: Discussionmentioning

confidence: 99%

Current use of neuromuscular blocking agents and antagonists in Korea: a 2018 survey

et al. 2019

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“…Anesthesia allows the performing of surgical procedures in a rapid, safe, and pleasant manner, producing analgesia, absence of awareness, and adequate muscle relaxation when needed [ 1 , 2 , 3 ]. A critical aspect of perioperative anesthetic care is the maintenance of homeostasis, including hemodynamic stability, oxygenation, ventilation, and temperature.…”

Section: Introductionmentioning

confidence: 99%

The Impact of General Anesthesia on Redox Stability and Epigenetic Inflammation Pathways: Crosstalk on Perioperative Antioxidant Therapy

Ritiu

Rogobete

Săndesc

et al. 2022

Cells

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Worldwide, the prevalence of surgery under general anesthesia has significantly increased, both because of modern anesthetic and pain-control techniques and because of better diagnosis and the increased complexity of surgical techniques. Apart from developing new concepts in the surgical field, researchers and clinicians are now working on minimizing the impact of surgical trauma and offering minimal invasive procedures due to the recent discoveries in the field of cellular and molecular mechanisms that have revealed a systemic inflammatory and pro-oxidative impact not only in the perioperative period but also in the long term, contributing to more difficult recovery, increased morbidity and mortality, and a negative financial impact. Detailed molecular and cellular analysis has shown an overproduction of inflammatory and pro-oxidative species, responsible for augmenting the systemic inflammatory status and making postoperative recovery more difficult. Moreover, there are a series of changes in certain epigenetic structures, the most important being the microRNAs. This review describes the most important molecular and cellular mechanisms that impact the surgical patient undergoing general anesthesia, and it presents a series of antioxidant therapies that can reduce systemic inflammation.

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“…However, frequently used neuromuscular monitoring patterns are always criticized for their diverse shortcomings ( Table 1 ). Despite its universal utilization in clinical settings, ACC is susceptible to artifacts and will probably generate an overrated block degree [ 12 , 14 ]. A conventional ACC-based apparatus records the monaxial movement of the target muscle; therefore, signal quality relies heavily on the posture of the recording sites [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Phonomyography on Perioperative Neuromuscular Monitoring: An Overview

Dong

2022

Sensors

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Complications related to neuromuscular blockade (NMB) could occur during anesthesia induction, maintenance, and emergency. It is recommended that neuromuscular monitoring techniques be utilized perioperatively to avoid adverse outcomes. However, current neuromuscular monitoring methods possess different shortcomings. They are cumbersome to use, susceptible to disturbances, and have limited alternative monitoring sites. Phonomyography (PMG) monitoring based on the acoustic signals yielded by skeletal muscle contraction is emerging as an interesting and innovative method. This technique is characterized by its convenience, stable signal quality, and multimuscle recording ability and shows great potential in the application field. This review summarizes the progression of PMG on perioperative neuromuscular monitoring chronologically and presents the merits, demerits, and challenges of PMG-based equipment, aiming at underscoring the potential of PMG-based apparatuses for neuromuscular monitoring.

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Neuromuscular monitoring: an update

Cited by 17 publications

References 56 publications

Current use of neuromuscular blocking agents and antagonists in Korea: a 2018 survey

Current use of neuromuscular blocking agents and antagonists in Korea: a 2018 survey

The Impact of General Anesthesia on Redox Stability and Epigenetic Inflammation Pathways: Crosstalk on Perioperative Antioxidant Therapy

Phonomyography on Perioperative Neuromuscular Monitoring: An Overview

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