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Anesthetic Agents and Surgery during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Anesthetic agent pharmacokinetics have been reported for only pancuronium, and its disposition was a pregnancy-associated decreased half-life, which was apparently due to significantly increased renal clearance (Little, 1999).
Critical care, neurology and analgesia
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Although pancuronium is an older drug, it continues to be widely used in clinical practice because it is an effective and inexpensive product with a known side-effect profile. Pancuronium causes tachycardia, which can lead to an increase in myocardial oxygen demand.
The Epidemiology Of Germinal Matrix/ Intraventricular Hemorrhage *
Published in Michele Kiely, Reproductive and Perinatal Epidemiology, 2019
Nigel Paneth, Jennifer Pinto-Martin
The specific techniques of mechanical ventilation have also come under scrutiny for their relationship to GM/IVH. Perlman and colleagues showed, in a randomized trial, that pancuronium, a muscle relaxing agent used during mechanical ventilation, significantly reduced the risk of GM/IVH.116 The rationale for this intervention was the investigators’ finding that this agent was able to abolish the fluctuations in cerebral blood flow velocity that they had previously linked to GM/IVH.
Effectiveness of Sugammadex on muscle relaxant reversal in preterm neonates
Published in Egyptian Journal of Anaesthesia, 2023
Ahmed Mohamed Ahmed Elshafie, Ahmed Ezzat Marzouq Sad Elrouby, Yasser Mohamed Osman
A selective muscle relaxant binding agent is called sugammadex. Sugammadex is a hydrophilic exterior that promotes solubility and a hydrophobic interior that encapsulates amino steroidal medicines. It is a donut-shaped cyclodextrin molecule. [3,4] Sugammadex binds to rocuronium with the highest affinity, but it also has a three-fold lower affinity for vecuronium. [5] Pancuronium is not much affected, while the benzylisoquinoliums and succinylcholine classes of muscle relaxants are unaffected. Acetylcholinesterase inhibitors like neostigmine, which compete to stop the breakdown of acetylcholine rather than directly opposing neuromuscular blockers, have long been the go-to antagonists. [6] Because Sugammadex interacts directly with steroidal relaxants, it is the only medicine now on the market that can reverse profound neuromuscular blockade. [6]
Successful treatment of a level IIIA tracheal rupture following endoscopic balloon dilation
Published in Acta Oto-Laryngologica Case Reports, 2023
Fredrik J. Landström, Eleftherios Ntouniadakis
Since intubation was considered unsafe the patient was transferred to the ICU ventilated with a Laryngeal Mask Airway (LMA). Muscle relaxation (pancuronium) was used to prevent coughing. Cefuroxim (1.5 g three times daily) was administered for prophylaxis. The patient remained afebrile, the C-reactive protein peaked at 50 mg/L and the leukocyte count was mildly increased. On the third post-operative day, the patient’s condition remained stable and following lidocaine infusion (1 mg/ml) to prevent coughing, the LMA was removed and she was transferred to the ward. Ethylmorphinehydrochloride (25 mg four times daily) was prescribed to minimize coughing. Six days postoperatively a new CT scan showed complete closure of the laceration (Figure 2). She was discharged after an eight-day admission and remained asymptomatic as she was followed uneventfully for more than ten years.
A pilot clinical study of the neuromuscular blocker rocuronium to reduce the duration of ventilation after organophosphorus insecticide poisoning
Published in Clinical Toxicology, 2020
Jeevan Dhanarisi, Fathima Shihana, Kirsi Harju, Fahim Mohamed, Vasundhara Verma, Seyed Shahmy, Paula Vanninen, Olli Kostiainen, Indika Gawarammana, Michael Eddleston
We previously assessed the effect of prophylactic administration of rocuronium in an experimental pig model of dimethoate EC40 poisoning and found some evidence of benefit (Eddleston et al., unpublished). A pig model of parathion poisoning is also being developed to test the efficacy of nicotinic antagonists [21], although no results have yet been published. A different NMBA, pancuronium, has previously been studied in OP insecticide poisoned patients [20,38,39]. A neurophysiological study of two patients showed transient improvement in compound muscle action potentials; a second study, of nine patients, suggested some partial improvement of NMJ block with single bolus doses of pancuronium. A subsequent study in a different group of seven patients showed a good response to a single dose of pancuronium but a deteriorating NMJ transmission when pancuronium followed pralidoxime therapy [40]. Administration of pancuronium to OP poisoned patients has not been reported since these studies.