Surgeon-controlled mivacurium administration during elective Caesarean section

Abdulatif, Mohamed; Taylouni, Entessar

doi:10.1007/bf03028259

Cited by 7 publications

(2 citation statements)

References 24 publications

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“…Upon exposure of the abdominal cavity however, very little block is required. Even with surgeon-controlled muscle relaxation, surgeons did not request complete neuromuscular block during open abdominal procedures [68] demonstrating that ideal surgical conditions can be accomplished in the absence of NMBAs.…”

Section: Submaximal Blockmentioning

confidence: 99%

Residual Paralysis: Does it Influence Outcome After Ambulatory Surgery?

Farhan

Moreno-Duarte

McLean

et al. 2014

Curr Anesthesiol Rep

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Neuromuscular blocking agents are used to facilitate tracheal intubation in patients undergoing ambulatory surgery. The use of high-dose neuromuscular blocking agents to achieve muscle paralysis throughout the case carries an increased risk of residual post-operative neuromuscular blockade, which is associated with increased respiratory morbidity. Visually monitoring the train-of-four (TOF) fade is not sensitive enough to detect a TOF fade between 0.4 and 0.9. A ratio <0.9 indicates inadequate recovery. Quantitative neuromuscular transmission monitoring (e.g., acceleromyography) should be used to exclude residual neuromuscular blockade at the end of the case. Residual neuromuscular blockade needs to be reversed with neostigmine, but it’s use must be guided by TOF monitoring results since deep block cannot be reversed, and neostigmine administration after complete recovery of the TOF-ratio can induce muscle weakness. The development and use of new selectively binding reversal agents (sugammadex and calabadion) warrants reevaluation of this area of clinical practice.

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Section: Submaximal Blockmentioning

confidence: 99%

Residual Paralysis: Does it Influence Outcome After Ambulatory Surgery?

Farhan

Moreno-Duarte

McLean

et al. 2014

Curr Anesthesiol Rep

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show abstract

“…In the control group, the anesthesiologist injected mivacurium according to the response of the nerve stimulator. Surgeons actually gave less neuromuscular blocking agent than anesthesiologists, 6 indicating that it is not always necessary to provide complete neuromuscular blockade. Finally, in a more recent study, King et al 7 gave either vecuronium or placebo to patients undergoing radical prostatectomy under isoflurane anesthesia.…”

mentioning

confidence: 99%