To see the other types of publications on this topic, follow the link: Muscle relaxants and sedation.
Journal articles on the topic 'Muscle relaxants and sedation'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Muscle relaxants and sedation.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Muralinath, E., Devi Pooja, Chbukdhara Prasanta, et al. "The Impact of Drugs on Muscle Relaxants: A Comprehensive Analysis." Research and Reviews: Journal of Wound, Ostomy and Continence Nursing 2, no. 1 (2023): 1–5. https://doi.org/10.5281/zenodo.10398876.
Full textAbstract:
<em>Muscle relaxants ate helpful on decreasing muscle spasms, pain and stiffness also. Muscle relaxants perform by affecting the Central nervous system and decrease nerve impulses that are responsible for causing muscle contractions. Muscle relaxants are frequently prescribed for a very few conditions namely chronic pain, Muscle spasms and certain neurological abnormalities. An example for common Muscle relaxants is baclofenac, cyclobenzaprine and tizanide. If alcohol combines with Muscle relaxants, It can enhance dizziness and drowsiness also. This interaction results in impairment of motor skills and coordination. The combination of opioid and muscle relaxants results in respiratory depression. The combination of tri cycle. Anti-depressants lead to occurrence of an increased sedation due to the effect of nerve impulses in the brain. The combination of benzodiazepines and muscle relaxants results in excessive drowsiness and impaired cognitive function. The combination of NSAID s and muscle relaxants may increase pain relief, but it may cause potential gastro intestinal side effects. Certain herbal supplements namely kava and valerian root show sedative effects and may interact with muscle relaxants. Finally it is concluded that an open communication with health care professionals, adhere to prescribed dosage and vigilant monitoring can help mitigate potential risks linked tovcombing muscle relaxants with ormther compounds.</em>
2
O'Connor, Michael F., and Michael F. Roizen. "Use of Muscle Relaxants in the Intensive Care Unit." Journal of Intensive Care Medicine 8, no. 1 (1993): 34–46. http://dx.doi.org/10.1177/088506669300800103.
Full textAbstract:
Muscle relaxants are now routinely used in intensive care units despite the relative paucity of literature regarding their use, safety, and efficacy in this setting. Although the theory of the pharmacology of muscle relaxants is simple, many clinicians involved in critical care receive little or no formal education about their use either in medical school or during postgraduate training. Proper dosing, careful monitoring, awareness of possible side effects, and adequate sedation facilitate safe use of muscle relaxants in the intensive care unit. Muscle relaxants are not, however, a substitute for sedatives, hypnotics, amnesties, or analgesics and should rarely, if ever, be used without appropriate sedation and analgesia. A wide variety of agents now available with substantial differences in dosing, pharmacology, and side-effect profiles makes clearly delineated indications for use and end points for discontinuation necessary. Using muscle relaxants without monitoring is like using antiarrhythmics without an electrocardiograph.
3
Horn-Oudshoorn, Emily J. J., Alisa M. Blekherov, Gerbrich E. van den Bosch, et al. "Sedation Prior to Intubation at Birth in Infants with Congenital Diaphragmatic Hernia: An International Survey on Current Practices." Neonatology 120, no. 4 (2023): 434–40. http://dx.doi.org/10.1159/000530573.
Full textAbstract:
<b><i>Introduction:</i></b> Infants with congenital diaphragmatic hernia (CDH) are commonly intubated immediately after birth. Consensus on whether to provide sedation prior to intubation in the delivery room is lacking, although avoidance of stress is especially important in this population with high risk of pulmonary hypertension. We aimed at obtaining an overview of local pharmacological interventions and at providing guidance on delivery room management. <b><i>Methods:</i></b> An electronic survey was sent to international clinicians in referral centres for prenatal and postnatally diagnosed infants with CDH. This survey addressed demographic information, use of sedation and/or muscle relaxant prior to intubation, and use of pain scales in the delivery room. <b><i>Results:</i></b> We received 93 relevant responses from 59 centres. Most centres were from Europe (<i>n</i> = 33, 56%), followed by North America (<i>n</i> = 16, 27%), Asia (<i>n</i> = 6, 10%), Australia (<i>n</i> = 2, 3%), and South America (<i>n</i> = 2, 3%). A total of 19% (11/59) of the centres routinely provided sedation prior to intubation in the delivery room, with midazolam and fentanyl being most often used. Methods of administration varied for all medications provided. Only 5 of 11 centres using sedation reported an adequate sedative effect prior to intubation. Muscle relaxants prior to intubation were used in 12% (7/59) of the centres, although not always in combination with sedation. <b><i>Conclusion:</i></b> This international survey shows a substantial variation in sedation practices in the delivery room and scarce use of both sedative agents and muscle relaxants prior to intubation of CDH infants. We provide guidance on developing protocols for pre-intubation medication in this population.
4
Guruprasad, M., Naidu K. Mohan, Prasad Ch Srinivas, et al. "Understanding Anti-Anxiety Medications, Muscle Relaxants and Sedative-Hypnotics in Dentistry." Journal of Research and Reviews in Dental Sciences 1, no. 1 (2024): 8–11. https://doi.org/10.5281/zenodo.11044660.
Full textAbstract:
<em>Dental anxiety is a general issue that influences many people. Often preventing them from seeking necessary dental care. To reduce this anxiety and ensure a comfortable experience, dentists may employ various medications. Among these are anti_ anxiety medications, core muscle relaxants and sedative_ hypnotics. Understanding these medications and their riles in dentistry is critical for both patients and dental professionals. Since benzodiazepines have relaxing properties, they are frequently utilized in dentistry. These drugs work by enhancing the effects of GABA, or gamma-aminobutyric acid a neurotransmitter that decreases brain activity. This results in feelings of relaxation as well as sedation. Examples of benzodiazepines used in dentistry include diazepam (valium) and lirazepam ( Ativan). They are administered in a typical manner orally before a dental procedure to help patients feel more at ease. Core muscle relaxants are frequently used in dentistry to reduce muscle tension and decrease discomfort especially during Procedures. These medications target skeletal muscles, assisting to relax them and facilitate dental work. By enhancing muscle relaxation, these medications can help in achieving better outcomes and patient comfort especially during dental treatments. Sedative_ hypnotics are frequently used in conjunction with local anesthetics to provide a mire comfortable and stress_ free experience fir patients undergoing dental procedures. The use of these medications in dentistry serves many purposes and these purposes include anxiety reduction, improved patient experience, muscle relaxants and sedation. Finally it is concluded that anti_ anxiety medications, muscle relaxants and sedative_ hypnotic play valuable roles in dentistry, assisting to reduce anxiety, decrease muscle tension and increase relaxation particularly during dental procedures.</em>
5
Guo, Hui, Qian Zhao, Su-Yan Li, et al. "Successful treatment of fatal asthma combined with a silent chest: A case report." Journal of International Medical Research 48, no. 5 (2020): 030006052092568. http://dx.doi.org/10.1177/0300060520925683.
Full textAbstract:
Fatal asthma is a rare and potentially fatal disease. This disease requires suitable treatment to achieve rehabilitation, especially when accompanied by other complications, such as a silent chest and severe bronchial spasm. A 36-year-old man presented with a 10-year history of asthma that broke out into persistent asthma attacks and cardiac arrest, and was accompanied by a silent chest for 18 hours. He recovered and was discharged without any sequelae after being treated by a ventilator, hormones, epinephrine, analgesics, sedation, and muscle relaxants. Comprehensive treatment with a ventilator, hormones, epinephrine, analgesics, sedation, and muscle relaxants has a good effect on fatal asthma combined with a silent chest.
6
Sarapultseva, Maria, and Alexey Sarapultsev. "Evaluation of General Anesthesia and Sedation and Follow-Up Compliance in Pediatric Dental Procedures: A Comprehensive Analysis of Long-Term Outcomes and Gender Differences." Dentistry Journal 12, no. 9 (2024): 277. http://dx.doi.org/10.3390/dj12090277.
Full textAbstract:
This retrospective study evaluated the effectiveness of different types of general anesthesia (GA) and sedation in pediatric dental procedures, focusing on treatment outcomes and follow-up compliance with an emphasis on gender differences. Clinical records of 1582 pediatric patients, aged 0–18 years, were analyzed to examine the distribution, duration and impact of anesthesia types on dental procedure complexity. The study population was divided into three age groups: 0–6, 7–12 and 13–18 years. We assessed follow-up attendance rates by gender and anesthesia type, calculated the decayed, missing and filled (DMF) index and evaluated the need for further treatment and reasons for retreatment. Our findings indicated that general anesthesia with inhalational agents and muscle relaxants was the most frequently used method (1260 instances), followed by nitrous oxide sedation (163 instances) and sevoflurane GA with a laryngeal mask airway (158 instances). Inhalational GA with muscle relaxants had the longest average duration (2.78 h) and the highest DMF index (7.43), reflecting its use in more severe dental conditions. Gender analysis revealed a slight male predominance in using inhalational GA with muscle relaxants (55.87% male vs. 44.13% female). Female patients demonstrated higher follow-up compliance across all periods. Overall, our results highlight the importance of tailored anesthesia and sedation plans, as well as follow-up protocols, in pediatric dentistry. This study provides valuable insights for practitioners in selecting appropriate anesthesia and sedation types and developing strategies to improve follow-up compliance and treatment success.
7
McPherson, Christopher. "Premedication for Endotracheal Intubation in the Neonate." Neonatal Network 37, no. 4 (2018): 238–47. http://dx.doi.org/10.1891/0730-0832.37.4.238.
Full textAbstract:
Endotracheal intubation, a common procedure in neonatal intensive care, results in distress and disturbs physiologic homeostasis in the newborn. Analgesics, sedatives, vagolytics, and/or muscle relaxants have the potential to blunt these adverse effects, reduce the duration of the procedure, and minimize the number of attempts necessary to intubate the neonate. The medical care team must understand efficacy, safety, and pharmacokinetic data for individual medications to select the optimal cocktail for each clinical situation. Although many units utilize morphine for analgesia, remifentanil has a superior pharmacokinetic profile and efficacy data. Because of hypotensive effects in preterm neonates, sedation with midazolam should be restricted to near-term and term neonates. A vagolytic, generally atropine, blunts bradycardia induced by vagal stimulation. A muscle relaxant improves procedural success when utilized by experienced practitioners; succinylcholine has an optimal pharmacokinetic profile, but potentially concerning adverse effects; rocuronium may be the agent of choice based on more robust safety data despite a relatively prolonged duration of action. In the absence of an absolute contraindication, neonates should receive analgesia with consideration of sedation, a vagolytic, and a muscle relaxant before endotracheal intubation. Neonatal units must develop protocols for premedication and optimize logistics to ensure safe and timely administration of appropriate agents.
8
Royaux, E., I. N. Plessas, and P. Smith. "Focal tetanus involving both thoracic limbs successfully treated with magnesium sulfate in a dog." Vlaams Diergeneeskundig Tijdschrift 89, no. 4 (2020): 221–25. http://dx.doi.org/10.21825/vdt.v89i4.16580.
Full textAbstract:
A six-year-old, male, neutered Cocker spaniel was referred for a three-week history of progressive thoracic limb stiffness. The dog became non-ambulatory due to severe thoracic limb stiffness, which was exacerbated by external stimuli. The pelvic limbs appeared to be normal. Based on the history and the physical examination, a presumptive diagnosis of focal tetanus of the thoracic limbs was made. The dog was treated supportively with tetanus antitoxin, antimicrobials, sedation and muscle relaxants; however, this treatment did not control the muscle spasms adequately. Magnesium sulphate was added to alleviate the muscle spasms and to reduce the sedation requirements. The dog improved and was discharged after three weeks of intensive treatment.
9
Goudra, Basavana, Lalitha Sundararaman, Prarthna Chandar, and Michael Green. "Anesthesia for Bronchoscopy—An Update." Journal of Clinical Medicine 13, no. 21 (2024): 6471. http://dx.doi.org/10.3390/jcm13216471.
Full textAbstract:
The field of interventional pulmonology has grown immensely and is increasingly recognized as a subspecialty. The new procedures introduced in the last decade pose unique challenges, and anesthesiologists need to readapt to their specific demands. In this review, we extensively discuss the pathophysiology, technical aspects, preprocedural preparation, anesthetic management, and postprocedural challenges of many new procedures such as navigational bronchoscopy, endobronchial valve deployment, and bronchial thermoplasty. Majority of these procedures are performed under general anesthesia with an endotracheal tube. Total intravenous anesthesia with rocuronium as a muscle relaxant seems to be the standard US practice. The easy availability and proven safety and efficacy of sugammadex as a reversal agent of rocuronium has decreased the need for high-dose remifentanil as an agent to avoid muscle relaxants. Additional research is available with regard to the utility of nebulized lidocaine and is discussed. Finally, two newer drugs administered for conscious sedation (typically without the need of an anesthesiologist) are likely to gain popularity in the future. Remimazolam is a new short-acting benzodiazepine with a relatively faster offset of clinical effects. Dexmedetomidine, a selective adrenergic agonist, is increasingly employed in bronchoscopy as a sedative during bronchoscopic procedures.
10
Gajapriya M and Lavanya Govindaraju. "Commonly Used Muscles Relaxant and Reversal Agents for Children Treated Under General Anaesthesia - A Retrospective Cohort Study." Journal of Advanced Zoology 44, S5 (2023): 3052–57. http://dx.doi.org/10.17762/jaz.v44is5.2349.
Full textAbstract:
Background: Pediatric patients going through dental systems and who are incredibly uncooperative, unfortunate, restless, or actually safe without any assumption for conduct improvement are gone through for general anaesthesia (GA) to do the treatment. Changes in the training and advancement of general sedative medications have impacted the utilization of muscle relaxants and inversion specialists in pediatric patients. Aims: The aim of the review was to survey the commonly used muscle relaxant and reversal agents for pediatric patients treated under general anesthesia in Saveetha dental college from March 2020 to February 2021. Setting and Design: A retrospective study was conducted on pediatric patients treated under general anesthesia to determine the commonly used muscle relaxants and reversal agents. Materials and Methods: From pediatric patients visiting private dental hospital, those who are treated under general anesthesia from March 2020 to February 2021 considered as inclusion . Exclusion criteria involve those who are not treated under general anesthesia. The final sample size 100. The age , gender, muscle relaxants and reversal agents prescribed were considered and tabulated and SPSS (Statistical Package for the Social Sciences, Chicago,USA) was used to analyze the data. The results were compared using descriptive statistics and Chi-square-test. Then 0.05 was set to be a P value for the level of significance. Results: From the results of the study, atracurium(99%) and vecuronium(1%) were the commonly used muscle relaxants and neostigmine + glycopyrrolate(100%) was the commonly used reversal agents for pediatric patients treated under general anesthesia. Conclusions: From the study , there were only a few standard drugs like atracurium and vecuronium used as muscle relaxant and neostigmine + glycopyrrolate reversal agents were used for pediatric patients who were treated under general anesthesia .
11
Bandt, Carsten, Elizabeth A. Rozanski, Tanja Steinberg, and Scott P. Shaw. "Retrospective Study of Tetanus in 20 Dogs: 1988–2004." Journal of the American Animal Hospital Association 43, no. 3 (2007): 143–48. http://dx.doi.org/10.5326/0430143.
Full textAbstract:
The case records of 20 dogs that were treated for tetanus between 1988 and 2004 were reviewed. Young, large-breed dogs were most commonly affected. Twelve dogs had a likely source of infection identified. All dogs were treated with intravenous antibiotics and supportive care, such as muscle relaxants and sedation for muscle tremors and rigidity. Sixteen dogs received tetanus antitoxin. The mortality rate was 50%. Complete recovery in survivors required approximately 1 month.
12
Titova, N. V. "Tolperisone for the treatment of low back pain." Clinical pharmacology and therapy 33, no. 2 (2022): 14–19. http://dx.doi.org/10.32756/0869-5490-2022-2-14-19.
Full textAbstract:
Tolperisone is a centrally acting muscle relaxant that shows analgesic activity and can be used alone or in combination with NSAIDs for the treatment of nonspecific back pain. Compared with other muscle relaxants tolperison has better safety profile and very low sedative activity. New extendedrelease form of tolperisone (Midocalm Long 450 mg) has optimized pharmacokinetic properties, which enable stable therapeutic blood concetrantion of active substance over 24 hours. Once-daily administration of prolonged acting drug improves adherence to treatment.
13
Koçkuzu, Esra, Ali Korulmaz, Ümit Altuğ, Gürkan Bozan, and Dinçer Yıldızdaş. "Sedation - analgesia - muscle relaxant - withdrawal and delirium practices in pediatric intensive care units in Türkiye." Turkish Journal of Pediatrics 66, no. 5 (2024): 556–66. http://dx.doi.org/10.24953/turkjpediatr.2024.4830.
Full textAbstract:
Background. Pain and sedation management is an integral part of pediatric intensive care practice. Sedoanalgesia management must be balanced in order to optimize comfort and avoid complications. In order to achieve this balance, sedoanalgesia management needs to be clarified in pediatric intensive care units (PICU). With this study, we aimed to investigate sedation, analgesia, withdrawal and delirium practices, pharmacologic agent preferences, and current experiences and practices in scoring systems in PICUs in Türkiye. Method. A questionnaire consisting of 57 questions was sent via e-mail to the ‘Pediatric Intensive Care and Emergency’ group, which includes all intensive care specialists, subspecialty students and lecturers in Türkiye. Results. Our study involved 36 pediatric intensive care physicians working in PICUs in Türkiye. Among the PICU specialists who participated in the study, 83.3% stated that they performed routine assessments of sedation efficacy. While dexmedetomidine was the most commonly used sedative agent in patients undergoing noninvasive mechanical ventilation, benzodiazepines were the most preferred pharmacologic agent for sedation during mechanical ventilation. Of the pediatric intensivists who participated in the study, 94.4% stated that they performed routine pain assessments in their units. Of the PICU specialists who participated in the study, 69.4% stated that muscle relaxants were most commonly used to prevent patient-ventilator incompatibility during mechanical ventilation. Of the participants, 88.8% made withdrawal assessments when discontinuing sedo-analgesic agents. Delirium assessment was routinely performed by 58.3% of the participants. Conclusions. This study showed that the practices in sedoanalgesia management in PICUs in Türkiye are in parallel with recommendations of the sedation guideline. Despite the increased sensitivity in sedoanalgesia management, awareness in the management of delirium and withdrawal syndrome is not at the desired level. Therefore, there is a need to develop guidelines, raise awareness and increase training on these issues in our Türkiye.
14
Freebairn, R., G. M. Joynt, J. Lipman, and P. A. Bothma. "A Double-blind Comparison of Vecuronium Administered by the Springfusor® Infusion Device to Vecuronium by Intermittent Bolus Injection in Critically Ill Adult Patients." Anaesthesia and Intensive Care 22, no. 5 (1994): 580–85. http://dx.doi.org/10.1177/0310057x9402200514.
Full textAbstract:
To evaluate the Springfusor® infusion device for clinical use in an Intensive Care Unit and to compare the technique of intermittent bolus and constant infusion of muscle relaxants, we undertook a prospective double-blind randomized placebo-controlled study. Twenty critically ill ventilated patients requiring muscle paralysis were investigated. Although we could show no clinical advantage in infusing vecuronium, the Springfusor® provided a more constant level of paralysis compared with hourly bolus doses. The device is robust, easy to use and reduces nursing workload. This may translate into cost-saving improvement in patient care if the Springfusor® is used to provide muscle relaxation, sedation and analgesia.
15
Calvo, Aitana, Mercedes González-Hidalgo, Ana Terleira, Nieves Fernández, and Antonio Portolés. "Carisoprodol Single and Multiple Dose PK-PD. Part II: Pharmacodynamics Evaluation Method for Central Muscle Relaxants. Double-Blind Placebo-Controlled Clinical Trial in Healthy Volunteers." Journal of Clinical Medicine 11, no. 4 (2022): 1141. http://dx.doi.org/10.3390/jcm11041141.
Full textAbstract:
Centrally acting skeletal muscle relaxants (CMR) such as carisoprodol are used to treat acute, painful musculoskeletal conditions, though its precise mode of action has not been characterized. A double-blinded, placebo-controlled, randomized clinical trial was designed to evaluate the pharmacokinetics–pharmacodynamics (PKPD) of CMR after single (350 mg), double (700 mg), and multiple doses (up to 350 mg/8 h, 14 days) of carisoprodol. Muscular (Electromyogram–EMG, muscular strength dynamometry), central (sedation), and tolerability (psychomotor activity test, adverse events) parameters, as well as withdrawal symptoms, were evaluated. Thirteen healthy volunteers were enrolled. No evidence of direct muscle relaxation was evidenced, but some differences on sedation were evidenced throughout the study, suggesting that CMRs act, at least partly, through sedation. Most significant differences were detected at 1.5 h after dosing. The effect on psychomotor impairment was variable, most prominently after 1.5 h, too, suggesting that it is produced by carisoprodol rather than by meprobamate. No withdrawal symptoms were detected, so the risk of dependence following maximum doses and duration of treatment recommended, and under medical supervision, should be low.
16
Ohshita, Naohiro, Saeko Oka, Kaname Tsuji, et al. "Anesthetic Management of a Patient With Charcot-Marie-Tooth Disease." Anesthesia Progress 63, no. 2 (2016): 80–83. http://dx.doi.org/10.2344/15-00010r1.1.
Full textAbstract:
Charcot-Marie-Tooth disease (CMTD) is a hereditary peripheral neuropathy and is characterized by progressive muscle atrophy and motor-sensory disorders in all 4 limbs. Most reports have indicated that major challenges with general anesthetic administration in CMTD patients are the appropriate use of nondepolarizing muscle relaxants and preparation for malignant hyperthermia in neuromuscular disease. Moderate sedation may be associated with the same complications as those of general anesthesia, as well as dysfunction of the autonomic nervous system, reduced perioperative respiratory function, difficulty in positioning, and sensitivity to intravenous anesthetic agents. We decided to use intravenous sedation in a CMTD patient and administered midazolam initially and propofol continuously, with total doses of 1.5 mg and 300 mg, respectively. Anesthesia was completed in 3 hours and 30 minutes without adverse events. We suggest that dental anesthetic treatment with propofol and midazolam may be effective for patients with CMTD.
17
Takahashi, Ken, Tomoka Matsumura, Yushi Abe, et al. "Perioperative Management of a Patient With Tongue Cancer Who Developed Pneumomediastinum Following Tracheostomy Performed to Secure the Airway." Anesthesia Progress 69, no. 4 (2022): 37–39. http://dx.doi.org/10.2344/anpr-69-03-02.
Full textAbstract:
Prior to a scheduled operation for a 45-year-old male patient with tongue cancer, a tracheotomy performed under intravenous sedation to prevent asphyxia due to extensive bleeding resulted in pneumomediastinum and subcutaneous emphysema. The planned operations were postponed until reduction of the pneumomediastinum was confirmed. During operation, airway pressure was kept low to prevent tension pneumomediastinum along with a sufficient depth of anesthesia, controlled analgesia, and continuous administration of muscle relaxants. Postoperatively, sedation was used to avoid stress and complications with the vascular anastomosis site. In this case, air leakage into the soft tissues was one of the possible causes of the event associated with increased airway pressure. Although the incidence of such complications is relatively low, caution should be exercised after tracheostomy.
18
Kozanhan, Betul, Betul Basaran, Leyla Kutlucan, and Sadık Ozmen. "Paravertebral Block Combined with Sedation for a Myasthenic Patient Undergoing Breast Augmentation." Case Reports in Anesthesiology 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/593282.
Full textAbstract:
Paravertebral block is a unilateral analgesic technique that can provide adequate surgical anesthesia and great advantages in many types of surgery with a low side-effect profile. In this case we present combination of bilateral thoracic paravertebral block under ultrasound guidance with sedation which provides complete anesthesia and postoperative analgesia in a myasthenic patient undergoing cosmetic breast surgery. In myasthenic patients paravertebral blocks may be a better option for breast surgery with avoiding the need for muscle relaxants and opioids and risk of respiratory failure in postoperative period.
19
de Sotomayor, M. Alvarez, M. D. Herrera, C. Perez-Guerrero, and E. Marhuenda. "Uterine Relaxant Effect of Zolpidem: A Comparison with Other Smooth Muscle Relaxants." Zeitschrift für Naturforschung C 52, no. 9-10 (1997): 687–93. http://dx.doi.org/10.1515/znc-1997-9-1018.
Full textAbstract:
Zolpidem is an imidazopyridine sedative-hypnotic which interacts with central benzodiazepine- receptors. To examine its effects on uterine smooth muscle we have compared with those obtained by diltiazem, papaverine and diazepam on different experimental models. The IC50 values obtained indicate similar behaviour of zolpidem and diazepam. They showed more active against the spontaneous contractions and those induced by KCl (60 mᴍ) or by CaCl2 (0.01-10 mᴍ) in Ca2+-free depolarizing medium than against acetylcholine (0.1 mᴍ)-induced contractions. Both of them also showed more effectiveness against the tonic component of the acetylcholine-evoked contraction than against the phasic one. All the drugs tested were less powerful against contractions induced by oxytocin than against those induced by other agonists. This observation let us speculate that the mechanism of action of zolpidem may be related to an action on Ca2+ influx through voltage-dependent Ca2+ channels due to an interaction with low affinity receptor located at the plasmalemma as has been suggested for diazepam
20
Madathil, Thushara, Devika Poduval, Tony Jose, et al. "Our Experience of Managing Central Airway Tumors: Anesthesia Perspectives." Annals of Cardiac Anaesthesia 28, no. 1 (2025): 3–9. https://doi.org/10.4103/aca.aca_118_24.
Full textAbstract:
ABSTRACT Adult patients with central airway tumors commonly present with dyspnea on exertion. These patients may remain asymptomatic until more than half of the airway diameter is obliterated. Anesthesia for debulking a central airway tumor is challenging. Anesthetic management should include a strategy for oxygenation and ventilation, a plan for the same if tumor bleeding aggravates airway obstruction and a plan to deal with acute emergencies like pneumothorax and cardiac arrest. Patients with airway tumors occupying < 50% airway diameter and comfortable during routine activities can be managed using relaxant anesthesia and rigid bronchoscopy for debulking. Airway tumors with >75% airway lumen compromise are the sickest and may present in respiratory failure. We found that in these patients, maintaining spontaneous ventilation, avoidance of general anesthesia, and muscle relaxation are the keys to management. General anesthesia and muscle relaxants decreases / abolishes negative intrapleural pressure, which may result in dynamic hyperinflation and pneumothorax in presence of airway obstruction. In this subset, we routinely use i-gel (sizes 4 and 5) as an airway conduit for debulking. We prefer i-gel® (Intersurgical Ltd, UK) over rigid bronchoscopy as it requires less sedation. To allow this, it is prudent to ensure excellent airway anesthesia prior to i-gel placement using airway blocks, topical anesthetics, and titrated doses of sedation. We manage 20–30 cases of central airway tumors for debulking or stenting every year and share our experience of managing four cases depicting a spectrum of airway and review the literature on anesthetic management of central airway tumors.
21
Rajput, J. K., P. H. Patil, S. J. Surana, and A. A. Shirkhedkar. "Analytical Methods for Determination of Muscle Relax-ant Thiocolchicoside in Pharmaceutical Preparations- A Review." Open Pharmaceutical Sciences Journal 2, no. 1 (2015): 43–55. http://dx.doi.org/10.2174/1874844901502010043.
Full textAbstract:
Thiocolchicoside is a centrally acting muscle relaxant and used in combination with many NSAIDs for the treatment of various musculoskeletal disorders. As it is less sedative than other centrally acting muscle relaxants hence frequently prescribed for low back pain (LBP), orthopedic, traumatic and rheumatologic disorders. It is available in market in single component and as multicomponent formulations. Various analytical methods are available for determination of thiocolchico-side in drug substances and formulated products. The present article summarizes more than 100 analytical methods including all types of chromatographic, UV-Visible spectrophotometry and radio immune assays with their percentage of utility for de-termination of thiocolchicoside in biological matrices, bulk material and different pharmaceutical formulations.
22
Aljohani, Abdullah S. M., Fahad A. Alhumaydhi, Abdur Rauf, Essam M. Hamad, and Umer Rashid. "In Vivo Anti-Inflammatory, Analgesic, Sedative, and Muscle Relaxant Activities and Molecular Docking Analysis of Phytochemicals from Euphorbia pulcherrima." Evidence-Based Complementary and Alternative Medicine 2022 (April 13, 2022): 1–9. http://dx.doi.org/10.1155/2022/7495867.
Full textAbstract:
Euphorbia pulcherrima is an important medicinal plant that is used in a traditional system for its curative properties such as analgesic potency, antipyretic, anti-inflammatory, sedation potential, and antidepressant and cure of diseases such as skin diseases. This study deals with the isolation of two flavonoids namely spinacetin (1) and patuletin (2) from chloroform fraction of Euphorbia pulcherrima. The isolated compound spinacetin (1) and patuletin (2) were screened for in vivo anti-inflammatory, analgesic, sedative, and muscle relaxant effects. Compounds 1 and 2 were assessed against hot plate-induced noxious stimuli at various doses which showed excellent ( p < 0.05 ) analgesic effect in a dose-dependent manner. The muscle relaxant activity was determined by traction and inclined screening model, both compounds showed significant muscle relaxant activity with time. The sedative potential of isolated compounds 1 and 2 was determined by the open field model, both compounds showed good sedation ( p < 0.05 ) at 20 mg/kg. The anti-inflammatory potential of compound 1 was recorded by histamine-induced paw edema and carrageen paw edema model, and in both models, compounds 1 and 2 showed strong effect at 20 mg/kg. Binding orientations, binding energy values, and computed inhibition constants (Ki) values revealed that the studied compounds have a good to excellent inhibition potential against μ-opioid receptors and COX-2.
23
Nin, Itsuhiro, Yoshihisa Fujino, Emi Fujii, and Hiromi Kato. "Total intravenous anesthesia using remimazolam for primary lateral sclerosis." Research and Opinion in Anesthesia & Intensive Care 11, no. 3 (2024): 201–3. http://dx.doi.org/10.4103/roaic.roaic_65_23.
Full textAbstract:
Primary lateral sclerosis (PLS) is an extremely rare neurodegenerative muscle disease of unknown cause. The choice of anesthesia for surgery in patients with neurodegenerative muscle disease is extremely important, as it may affect the patient’s prognosis. In this case report, we describe a 74-year-old man with PLS who underwent surgical closure of the larynx owing to repeated aspiration pneumonia. The surgery was performed without muscle relaxants and with total intravenous anesthesia using remimazolam, a relatively new, ultra-short-acting benzodiazepine sedative. The patient underwent surgery safely with no complications and had stable intraoperative hemodynamics. General anesthesia using remimazolam and remifentanil without muscle relaxants may be an appropriate anesthesia technique in patients with PLS who require surgery.
24
Trinh, Van N., and Joseph E. Villaluz. "A Case Series on the Utility of Dexmedetomidine for the Immediate Treatment of Postoperative Muscle Spasm." Journal of Anesthesiology and Pain Therapy 4, no. 1 (2023): 17–21. http://dx.doi.org/10.29245/2768-5365/2023/1.1139.
Full textAbstract:
Postoperative muscle spasm is a common complaint in the post-anesthesia care unit. Management of postoperative muscle spasm remains a major challenge as first-line anti-spasmodic agents are not without risk. Due to the adverse effects of sedation and risk for respiratory depression and pulmonary aspiration, conventional anti-spasmodic agents may not be an ideal choice for patients who are recovering from anesthesia. In this case series, we present three patients who underwent nonemergent surgeries with subsequent postoperative cervical muscle spasm that went unresolved with conventional PACU pain medications. Below, we demonstrate the potential utility of dexmedetomidine for management of postoperative muscle spasm. This is most notable when oral anti-spasmodic formulations are contraindicated in sedated patients and intravenous skeletal muscle relaxants are inaccessible in the PACU. After receiving incremental boluses of dexmedetomidine, the patients demonstrated immediate improvement in their cervical range of motion and their cervical muscle spasms were markedly reduced. Dexmedetomidine’s unique qualities, such as its quick onset, intravenous route of administration, and minimal effect on respiratory physiology, make it an ideal choice for management of postoperative muscle spasm.
25
Frasca, Luca, Antonio Sarubbi, Filippo Longo, et al. "Remifentanil-Propofol-Ketamine- Based Total Intravenous Anesthesia with Spontaneous Breathing for Adult Rigid Bronchoscopy." Journal of Clinical Medicine 14, no. 2 (2025): 377. https://doi.org/10.3390/jcm14020377.
Full textAbstract:
Background: Rigid bronchoscopy (RB) is the gold standard for managing central airway obstruction (CAO), a life-threatening condition caused by both malignant and benign etiologies. Anesthetic management is challenging as it requires balancing deep sedation with maintaining spontaneous breathing to avoid airway collapse. There is no consensus on the optimal anesthetic approach, with options including general anesthesia with neuromuscular blockers or spontaneous assisted ventilation (SAV). Methods: This case series presents our anesthetic protocol using remifentanil–propofol–ketamine total intravenous anesthesia (TIVA) with SAV in four patients with airway obstructions. Muscle relaxants were avoided in all cases. Results: Ketamine’s ability to preserve respiratory drive and airway reflexes, along with its bronchodilating properties, made it ideal for managing CAO. All procedures successfully restored airway patency without complications or drug-related side effects. Conclusions: Our findings suggest that remifentanil–propofol–ketamine TIVA combined with SAV is a viable anesthetic approach for therapeutic RB, offering effective sedation, maintaining airway patency, and minimizing perioperative complications.
26
Vivien, Benoît, Sophie Di Maria, Alexandre Ouattara, Olivier Langeron, Pierre Coriat, and Bruno Riou. "Overestimation of Bispectral Index in Sedated Intensive Care Unit Patients Revealed by Administration of Muscle Relaxant." Anesthesiology 99, no. 1 (2003): 9–17. http://dx.doi.org/10.1097/00000542-200307000-00006.
Full textAbstract:
Background Electromyographic activity has previously been reported to elevate the Bispectral Index (BIS) in patients not receiving neuromuscular blockade while under sedation in the intensive care unit. This study aimed to investigate the magnitude of the decrease of BIS following administration of muscle relaxant in sedated intensive care unit patients. Methods The authors prospectively investigated 45 patients who were continuously sedated with midazolam and sufentanil to achieve a Sedation-Agitation Scale value equal to 1 and who required administration of muscle relaxant. BIS (BIS version 2.10), electromyography, and acceleromyography at the adductor pollicis muscle were recorded simultaneously before and after neuromuscular blockade. Sixteen of these 45 patients were also studied simultaneously with the new BIS XP. Results After administration of a muscle relaxant, BIS (67 +/- 19 vs. 43 +/- 10, P &lt; 0.001) and electromyographic activity (37 +/- 9 vs. 27 +/- 3 dB, P &lt; 0.001) significantly decreased. Multiple regression analysis showed that the decrease of BIS following administration of myorelaxant was significantly correlated to BIS and electromyographic baseline values. Using standard BIS range guidelines, the number of patients under light or deep sedation versus general anesthesia or deep hypnotic state was markedly overestimated before administration of myorelaxant (53 vs. 2%, P &lt; 0.001). Conclusions The BIS in sedated intensive care unit patients may be lower with paralysis for an equivalent degree of sedation because of high muscular activity. The magnitude of BIS overestimation is significantly correlated to both BIS and electromyographic activity before neuromuscular blockade. The authors conclude that clinicians who determine the amount of sedation in intensive care unit patients only from BIS monitoring may expose them to unnecessary oversedation.
27
Anton-Martin, Pilar, Vinai Modem, Donna Taylor, Donald Potter, and Cindy Darnell-Bowens. "A retrospective study of sedation and analgesic requirements of pediatric patients on extracorporeal membrane oxygenation (ECMO) from a single-center experience." Perfusion 32, no. 3 (2016): 183–91. http://dx.doi.org/10.1177/0267659116670483.
Full textAbstract:
Introduction: The purpose of this study is to describe the sedative and analgesic requirements identifying factors associated with medication escalation in neonates and children supported on ECMO. Method: Observational retrospective cohort study in a tertiary pediatric intensive care unit from June 2009 to June 2013. Results: One hundred and sixty patients were included in the study. Fentanyl and midazolam were the first line agents used while on ECMO. Higher opiate requirements were associated with younger age (p=0.01), thoracic cannulation (p=0.002), the use of dexmedetomidine (p=0.007) and prolonged use of muscle relaxants (p=0.03). Higher benzodiazepine requirements were associated with younger age (p=0.01), respiratory failure (p=0.02) and the use of second line agents (p=0.002). One third of the patients required second line agents as adjuvants for comfort without a decrease in opiate and/or benzodiazepine requirements. Conclusions: Providing comfort to subpopulations of pediatric ECMO patients seems to be more challenging. The use of second line agents did not improve comfort in our cohort. Prospective studies are required to optimize analgesia and sedation management in children on ECMO.
28
Arai, Yukiko, Akari Hasegawa, Aki Kameda, et al. "A Case of Nasal Mucosa Cautery With Reintubation Under Pharyngeal Suction for Massive Epistaxis After Extubation." Anesthesia Progress 68, no. 4 (2021): 235–37. http://dx.doi.org/10.2344/anpr-68-03-04.
Full textAbstract:
We describe a case of massive epistaxis that occurred after removal of a nasal endotracheal tube, prompting emergent reintubation. Mask ventilation could not be performed because the nasal cavity was packed with gauze and the airway was being evacuated with a suction catheter. Therefore, instead of inhalational anesthetics and muscle relaxants, boluses of midazolam and remifentanil were administered, and reintubation was promptly performed. Sedation was maintained with dexmedetomidine infusion and midazolam. Nasal cautery was performed near the left sphenopalatine foramen. The patient was extubated without agitation or additional hemorrhage. Immediate recognition of the potential for airway loss, sufficient control of active bleeding, and drug selection in accordance with the emergent circumstances enabled prompt resecuring of the airway without pulmonary aspiration of blood.
29
Szederjesi, Janos, Irina Săplăcan, Alexandra Lazăr, et al. "Target-Controlled Sedation with Propofol Infusion for PEG-J Placement in Advanced Parkinson’s Disease: A Prospective Observational Study on Safety and Feasibility." Life 15, no. 3 (2025): 492. https://doi.org/10.3390/life15030492.
Full textAbstract:
Introduction: The management of sedation during percutaneous endoscopic gastrojejunostomy (PEG-J) placement in patients with advanced Parkinson’s disease (PD) is challenging due to the complex interactions between PD treatment, anesthetic agents, and the disease’s motor and non-motor symptoms. This study evaluates the effectiveness and safety of a target-controlled infusion (TCI) propofol protocol in the context of PEG-J placement in advanced PD patients. Materials and Methods: This prospective study included 169 patients diagnosed with advanced Parkinson’s disease (Hoehn and Yahr stages 4 and 5) who underwent PEG-J placement at Târgu Mureș County Emergency Clinical Hospital, Romania. Sedation was induced and maintained using TCI propofol, with additional benzodiazepines and short-acting opioids, while muscle relaxants were not used. Procedural success rates and adverse outcomes were assessed for 30 days post-procedure. Results: The sedation protocol demonstrated a high procedural success rate. No deaths were reported within 30 days post-procedure. Conclusion: This study highlights the feasibility and clinical applicability of a TCI propofol protocol for PEG-J placement in patients with advanced PD (stages 4 and 5). While no deaths were recorded within the 30-day follow-up, the sample size is insufficient to draw definitive conclusions regarding long-term safety.
30
HN, Nethra. "Abstract No. : ABS0646: Efficacy of combined epidural general anaesthesia in laparoscopic cholecystectomies - a prospective randomised study." Indian Journal of Anaesthesia 66, Suppl 1 (2022): S67. http://dx.doi.org/10.4103/0019-5049.340768.
Full textAbstract:
Background &Aims: Pnuemoperitonium in laparoscopy is associated with cardiorespiratory changes. Combination of epidural with general anaesthesia might offer benefits of haemodynamic control and peri-operative analgesia. We aimed to study the efficacy of combinedepidural-general anaesthesia(CEGA) over general anaesthesia in laparoscopic cholecystectomies. Methods: A prospective, randomised, double blind study was conducted on 90 surgical in-patients after obtaining ethical and informed consent from the institution and participants respectively.In Group GE-(n=45), Lumbar epidural analgesia with ropivacaine with GA ;In Group G, only GA was administered. Propofol ,vecuronium, fentanyl, paracetamol, isofluranewereused in both the groups. Along with minimum mandatory monitoringfor study purpose, heart rate(HR), mean arterial Pressure(MAP), end-tidal carbon-dioxide (ETCO2), peripheral oxygen saturation ( SpO2) ,visualanaloguescale score, Ramsay sedation score , requirement of propofol, muscle relaxants and analgesics were studied with recovery and pain in 12 hours post operatively.Statistical analysis was carried out with SPSS version 20. Student’s t test, Chi-square test were used for comparison. Results: Statistical value of p<0.05 was considered significant. We noted significantly lesser readingsin group GE than inGroup G i.e (p<0.001) in MAP, SBP, DBP muscle relaxants, propofol and Fentanyl (p<0.001) . Early recovery and lesser pain scores were noted in group GE than Group G. Conclusion: CEGAtechnique has the benefit of better control of haemodynamics .It reduces requirements of analgesics and anaesthetic drugs and has faster recovery with less post-operative pain in laparoscopic cholecystectomies.
31
Manchikanti, Laxmaiah. "ASIPP Guidelines for Sedation and Fasting Status of Patients Undergoing Interventional Pain Management Procedures." Pain Physician 3, no. 22;3 (2019): 201–7. http://dx.doi.org/10.36076/ppj/2019.22.201.
Full textAbstract:
Many of the patients undergoing interventional procedures have daily regimens of medications including analgesics, muscle relaxants, and other drugs that can have significant additive/synergistic effects during the perioperative period. Further, many patients also present with comorbid states, including obesity, cardiovascular, and pulmonary disease. Consequently, in the perioperative period, a significant number of patients have suffered permanent neurologic injury, hypoxic brain injury, and even death as a result of over sedation, hypoventilation, and spinal cord injury. In addition, physicians are concerned about aspiration, subsequent complications, and as a result, they ask patients to fast for several hours prior to the procedures. Based on extensive literature and consensus, a minimum fasting period is established as 2 hours before a procedure for clear liquids and 4 hours before procedure for light meals, rather than having all patients fast for 8 hours or even fasting beginning at midnight the night before the procedure. Gastrointestinal stimulants, gastric acid secretion blockers, and antacids may be used, even though not routinely recommended. Due to the nature of chronic pain and anxiety, many patients undergoing interventional techniques may require mild to moderate sedation. Deep sedation and/or general anesthesia for most interventional procedures is considered as unsafe, since the patient cannot communicate acute changes in symptoms, thus, resulting in morbidity and mortality, as well as creating compliance issues. We are adapting the published standards of the American Society of Anesthesiologists for monitoring patients under sedation, regardless of the location of the procedure, either office-based, in a surgery center, or a hospital outpatient department. These standards include monitoring of blood pressure, cardiac rhythm, temperature, pulse oximetry, and continuous quantitative end tidal CO2 monitoring. Sedation must be provided either by qualified anesthesia or non-anesthesia providers, with appropriate understanding of the medications, drug interactions, and resuscitative protocols. Key words: Guidelines, sedation, fasting status, monitoring, neurological complications
32
Diab, Kh M., N. A. Daikhes, A. A. Kaibov, O. A. Pashchinina, and A. S. Machalov. "Local anesthesia in surgical treatment of patients with otosclerosis with IV degree of hearing loss and deafness." Russian Otorhinolaryngology 19, no. 2 (2020): 28–37. http://dx.doi.org/10.18692/1810-4800-2020-2-28-37.
Full textAbstract:
The article presents the material devoted to the actual problem-rehabilitation of patients with otosclerosis with sensorineural hearing loss (SNHL) IV degree and deafness with concomitant diseases. Material and methods: on the basis of Clinical Research Center of Otorhinolaryngology in the Department of ear diseases cochlear implantation (CI) was performed in 4 patients with otosclerosis and comorbidities under local infiltration anesthesia and intravenous sedation with Dexdor drug, which allowed to avoid the introduction of muscle relaxants. In the preoperative period, patients were carefully prepared for the operation, acquainted with each stage of the operation, with tables for intraoperative dialogue. CI was performed by the classical method. Each patient was also interviewed for all parameters (during surgery and in the early postoperative period). Results. After parenteral administration of the drug, the effect was achieved quickly enough, against the background of drug administration, blood pressure did not increase to high figures relative to the norm, aggravation of comorbidities was not noted, patients felt satisfactory, responded to all signs, answered questions by reading from the tables. In no case did patients feel pain during incision, soft tissue separation, boron machine operation, introduction of cochlear implant electrode array and its subsequent testing. Conclusions. The advantages of local anesthesia using the Dexdor drug include: less invasiveness of the procedure; the ability not to use muscle relaxants; cost savings; finding the patient in consciousness, which makes it possible to intraoperatively diagnose the implant and assess the patient’s auditory perception when giving signals; determine the presence or absence of pathological stimulation of the facial nerve; reducing the time of surgery.
33
Yassen, Khaled Ahmed, Matthieu Jabaudon, Hussah Abdullah Alsultan, et al. "Inhaled Sedation with Volatile Anesthetics for Mechanically Ventilated Patients in Intensive Care Units: A Narrative Review." Journal of Clinical Medicine 12, no. 3 (2023): 1069. http://dx.doi.org/10.3390/jcm12031069.
Full textAbstract:
Inhaled sedation was recently approved in Europe as an alternative to intravenous sedative drugs for intensive care unit (ICU) sedation. The aim of this narrative review was to summarize the available data from the literature published between 2005 and 2023 in terms of the efficacy, safety, and potential clinical benefits of inhaled sedation for ICU mechanically ventilated patients. The results indicated that inhaled sedation reduces the time to extubation and weaning from mechanical ventilation and reduces opioid and muscle relaxant consumption, thereby possibly enhancing recovery. Several researchers have reported its potential cardio-protective, anti-inflammatory or bronchodilator properties, alongside its minimal metabolism by the liver and kidney. The reflection devices used with inhaled sedation may increase the instrumental dead space volume and could lead to hypercapnia if the ventilator settings are not optimal and the end tidal carbon dioxide is not monitored. The risk of air pollution can be prevented by the adequate scavenging of the expired gases. Minimizing atmospheric pollution can be achieved through the judicious use of the inhalation sedation for selected groups of ICU patients, where the benefits are maximized compared to intravenous sedation. Very rarely, inhaled sedation can induce malignant hyperthermia, which prompts urgent diagnosis and treatment by the ICU staff. Overall, there is growing evidence to support the benefits of inhaled sedation as an alternative for intravenous sedation in ICU mechanically ventilated patients. The indication and management of any side effects should be clearly set and protocolized by each ICU. More randomized controlled trials (RCTs) are still required to investigate whether inhaled sedation should be prioritized over the current practice of intravenous sedation.
34
Abed, Hassan, Ali Al-Qarni, Shanon Patel, and Abdulaziz Bakhsh. "Clinical tips for safe and effective root canal treatment under intravenous sedation with midazolam." Dental Update 50, no. 8 (2023): 695–98. http://dx.doi.org/10.12968/denu.2023.50.8.695.
Full textAbstract:
Intravenous (IV) sedation with midazolam works as an anxiolytic and muscle relaxant agent and has proved successful in providing safe root canal treatment (RCT) for patients with dental anxiety or special care needs. However, before starting RCT under IV sedation with midazolam, clinicians should consider obtaining a thorough medical history and written, informed consent including any significant or unavoidable risks. A responsible adult escort should also accompany the patient to their appointment. The dental team should also ensure labelling the IV sedation drugs and irrigant solutions, and using a well-sealed rubber dam. CPD/Clinical Relevance: This article provides clinical recommendations to help provide safe RCT under IV sedation with midazolam.
35
Rauf, Abdur, Yahya S. Al-Awthan, Imtaiz Ali Khan, et al. "In Vivo Anti-Inflammatory, Analgesic, Muscle Relaxant, and Sedative Activities of Extracts from Syzygium cumini (L.) Skeels in Mice." Evidence-Based Complementary and Alternative Medicine 2022 (April 11, 2022): 1–7. http://dx.doi.org/10.1155/2022/6307529.
Full textAbstract:
In the current study, the folklore medicine, Syzygium cumini, was experimentally evaluated for anti-inflammatory, analgesic, sedative, and muscle relaxant effects. The extract and fractions of S. cumini were found safe up to 1000 mg/kg with no mortality, except for slight sedation as a minor side effect. Both, the extract and various fractions of S. cumini demonstrated significant inhibition (86.34%) of carrageenan-induced inflammation in mice. Acetic acid induced writhes were attenuated ( p < 0.001 ) by S. cumini in a dose-dependent manner, except for the n-hexane fraction. The maximum effect was observed at a dose of 500 mg/kg in mice. The maximum muscle relaxant effect of all tested samples was recorded at a dose of 500 mg/kg bodyweight, where the percent inhibition exhibited by dichloromethane fraction was 82.34%, followed by chloroform fractions (71.43%) and methanolic extract (70.91%). Our findings validate the folklore medicinal claims of S. cumini, as an analgesic and anti-inflammatory agent.
36
Jovičić, Jelena, Miloš Lazić, Nataša Petrović, Jovanka Filipović, Vesna Jovanović, and Nikola Lađević. "Developments in the anesthesiology method for cystoscopy examination: Experience of the tertiary level institution: Anesthesia for cystoscopy examination." Serbian Journal of Anesthesia and Intensive Therapy 46, no. 1-2 (2024): 17–21. http://dx.doi.org/10.5937/sjait2402017j.
Full textAbstract:
Procedural sedation as an anesthesiological method performed in patients who are unable to tolerate the examination. Procedural sedation was defined for clinical situations which require conditions for performing a therapeutic or diagnostic procedure with protected spontaneous breathing, airway reflexes and hemodynamic stability, with absence of anxiety and pain. Endoscopic urological procedures represent a good therapeutic alternative to open surgical methods but with an incomparable advantage in diagnostics. Endoscopy experienced its expansion in the last 20 years as minimally invasive surgery. Cystourethroscopy is one of the most common procedures performed by a urologist. In a patient with an advanced bladder tumor, after examination with a cystoscope, bimanual palpation is performed requiring good muscle relaxation of the anterior abdominal wall. The Clinic for Urology and Nephrology has started with examination under a cystoscope during the sixties years of the last century. Originally without anesthesia condition, cystoscopies were performed under analgosedation conditions since 1980. Due to the length of the examination and the need to perform bimanual palpation examination this anesthetic approach was inadequate. Furthermore, cystoscopies were performed under general anesthesia, with the increasing dose of anxiolytics, followed with depolarizing muscle relaxants and hypnotics. Nowdays, cystoscopies are performed under general anesthesia, with inhalation anesthetic or propofol maintenance, both provided adequate conditions for examination. The changes of the anesthesiological method over time represents one of the testimonies of the evolutionary pharmacologicaly-technologicaly-personnel development of the anesthesiological specialty for the endoscopic procedure, which has not fundamentally and technically changed since the very beginning.
37
Rauf, Abdur, Ghias Uddin, Bina Shaheen Siddiqui, and Haroon Khan. "In vivo sedative and muscle relaxants activity of Diospyros lotus L." Asian Pacific Journal of Tropical Biomedicine 5, no. 4 (2015): 277–80. http://dx.doi.org/10.1016/s2221-1691(15)30345-2.
Full text
38
Elhammady, Mohamed Samy A., David M. Benglis, Sanjiv Bhatia, David I. Sandberg, and John Ragheb. "Ventriculoatrial shunt catheter displacement in a child with partial anomalous pulmonary venous return." Journal of Neurosurgery: Pediatrics 2, no. 1 (2008): 68–70. http://dx.doi.org/10.3171/ped/2008/2/7/068.
Full textAbstract:
Ventriculoatrial (VA) shunts remain the most used alternative to ventriculoperitoneal shunts in infants with hydrocephalus. The authors report a case of an acute VA shunt malfunction as a result of distal catheter displacement in an 18-month-old girl with partial anomalous pulmonary venous return. The child presented with respiratory compromise, and a chest radiograph revealed a lung infiltrate and normal position of the distal shunt catheter tip. Computed tomography demonstrated stable ventricle size in comparison with previous studies. As the patient's respiratory distress progressed, she required intubation, mechanical ventilation with high airway pressures and inspired oxygen concentrations, muscle relaxants, and sedation. A routine morning chest radiograph several days after admission revealed displacement of the distal catheter into the left innominate vein. Later that day the child's pupils were noted to be large and unreactive and a distal shunt malfunction was diagnosed. Complications of VA shunts and the presumed mechanism by which the catheter became displaced are discussed.
39
Syed, Moinuddin Omar, and Ameenuddin Ali Syed. "Intravenous Ketamine with Local Anaesthesia as an Alternative to General Anaesthesia for Orchidopexy in Children." International Journal of Pharmaceutical and Clinical Research 15, no. 10 (2023): 269–71. https://doi.org/10.5281/zenodo.11247143.
Full textAbstract:
<strong>Introduction: </strong>Undescended Testis is the most common birth defect of male genitalia. Two factors are very important in determining the type of anaesthesia in children, one is clinical presentation: palpable or impalpable and the second is unilateral or bilateral presentation. <strong>Material Method: </strong>This is a review of 243 Cases of Undescended Testis operated in our Institute over a period of 10 years. For cases of palpable testis with unilateral and occasionally bilateral presentation we used anaesthetic technique of Ketamine plus local infiltration. <strong>Results:</strong> Most Pediatric Surgeons prefer General Anaesthesia for children for doing Orchidopexy, but in selected cases like Unilateral, Palpable Undescended Testis Sedation by Intravenous Ketamine along with Local Anaesthesia can be safely used for Orchidopexy in children. With the use of Ketamine patients can be kept on spontaneous ventilation with oxygen by facemask, thereby avoiding the need for intubation and muscle relaxants that is required with use of General Anaesthesia.
40
Syed, Moinuddin Omar, and Ameenuddin Ali Syed. "Intravenous Ketamine with Local Anaesthesia as an Alternative to General Anaesthesia for Orchidopexy in Children." International Journal of Pharmaceutical and Clinical Research 15, no. 10 (2023): 314–16. https://doi.org/10.5281/zenodo.11247739.
Full textAbstract:
<strong>Introduction: </strong>Undescended Testis is the most common birth defect of male genitalia. Two factors are very important in determining the type of anaesthesia in children, one is clinical presentation: palpable or impalpable and the second is unilateral or bilateral presentation. <strong>Material Method: </strong>This is a review of 243 Cases of Undescended Testis operated in our Institute over a period of 10 years. For cases of palpable testis with unilateral and occasionally bilateral presentation we used anaesthetic technique of Ketamine plus local infiltration. <strong>Results:</strong> Most Pediatric Surgeons prefer General Anaesthesia for children for doing Orchidopexy, but in selected cases like Unilateral, Palpable Undescended Testis Sedation by Intravenous Ketamine along with Local Anaesthesia can be safely used for Orchidopexy in children. With the use of Ketamine patients can be kept on spontaneous ventilation with oxygen by facemask, thereby avoiding the need for intubation and muscle relaxants that is required with use of General Anaesthesia.
41
SANFORD, THEODORE J., MATTHEW B. WEINGER, N. TY SMITH, et al. "Pretreatment with Sedative-Hypnotics, but Not with Nondepolarizing Muscle Relaxants, Attenuates Alfentanil-Induced Muscle Rigidity." Survey of Anesthesiology 39, no. 4 (1995): 246. http://dx.doi.org/10.1097/00132586-199508000-00037.
Full text
42
Sanford, Theodore J., Matthew B. Weinger, N. Ty Smith, et al. "Pretreatment with sedative-hypnotics, but not with nondepolarizing muscle relaxants, attenuates alfentanil-induced muscle rigidity." Journal of Clinical Anesthesia 6, no. 6 (1994): 473–80. http://dx.doi.org/10.1016/0952-8180(94)90087-6.
Full text
43
Altundag, Yusuf, Tugba Kurt, Serhat Özsoy, and İbrahim Altundag. "Clinical evaluation of the intranasal administration of midazolam and reverse effects of flumazenil in Eurasian Buzzards (Buteo buteo)." Veterinarski arhiv 91, no. 6 (2021): 655–44. http://dx.doi.org/10.24099/vet.arhiv.1112.
Full textAbstract:
Midazolam, the most commonly used drug in birds, has sedative, muscle relaxant, anxiolytic, amnestic, and appetite-enhancing effects. In this study, we aimed to reach the proper sedation level with intranasal (IN) administration of midazolam, and quick and safe recovery with intranasal flumazenil application after a certain period of time. The buzzards in the experiment reached the desired and controllable sedation at 6.7 ± 1.6 min after administration of IN midazolam at a dose of 2 mg / kg of body weight. In the saline group (%0.9 NaCl), the doses of midazolam and flumazenil calculated according to their weight were administered intranasally as 0.9% NaCl. The heart rate was 290.4 ± 17.81 and 294.8 ± 18.19 beats/min in the midazolam group, and 300.8 ± 17.76 beats/min in the saline group. Cloacal temperature was 41.42 ± 07, 41.39 ± 0.85 °C in the midazolam group and 41.6 ± 0.45 °C in the saline group. The respiratory rate was 48.8 ± 4.5, 47.1 ± 4.3 breaths/min in the midazolam group and 54.6 ± 2.7 breaths/min in the saline group. Flumazenil was used as an antagonist at 0.05 mg/kg intranasally, and after 14.1 ± 1.8 minutes the sedation effect disappeared. Then the buzzards returned to their standard behavior. In conclusion, we suggest IN use of midazolam and use of flumazenil for faster recovery in buzzards as a simple, fast, practical, and economical mode of sedation for minimally invasive procedures.
44
Oldfield, Benjamin J., Brynna Gleeson, Kenneth L. Morford, et al. "Long-Term Use of Muscle Relaxant Medications for Chronic Pain." JAMA Network Open 7, no. 9 (2024): e2434835. http://dx.doi.org/10.1001/jamanetworkopen.2024.34835.
Full textAbstract:
ImportanceStricter opioid prescribing guidelines have increased prescriptions of skeletal muscle relaxants (SMRs) for chronic pain, but the efficacy of long-term use of SMRs for chronic pain is unknown.ObjectiveTo systematically review the effectiveness or efficacy of long-term use of SMRs for chronic pain.Evidence ReviewTwo reviewers systematically searched Ovid MEDLINE, Embase (Ovid), Web of Science, CINAHL, and Cochrane through December 4, 2023. They included articles published in English, Spanish, or Italian. Only randomized clinical trials (RCTs) and cohort studies with comparator groups evaluating at least 1-month duration of SMRs for chronic pain were included. The reviewers dually reviewed data abstraction, risk-of-bias, and quality. They characterized studies by chronic pain syndrome: low back pain, fibromyalgia, headaches, painful cramps or spasticity, and other syndromes.FindingsA total of 30 RCTs with 1314 participants and 14 cohort studies with 1168 participants assessed SMRs for chronic pain. Studies were primarily short-term (4-6 weeks). Nine unique SMRs were represented by the studies identified. Eleven studies (25%) examined baclofen, 8 (18%) examined tizanidine, and 7 (16%) examined cyclobenzaprine. Evidence for effectiveness was strongest for SMRs used for trigeminal neuralgia, neck pain, and painful cramps; evidence suggested SMRs for fibromyalgia, low back pain, and other syndromes were not more beneficial than placebo. The most common adverse effects were sedation and dry mouth. RCTs had a low to moderate risk of bias, and the quality of cohort studies was fair to good.Conclusions and RelevanceIn this systematic review of long-term use of SMRs for chronic pain, findings suggest that their long-term use may benefit patients with painful spasms or cramps and neck pain; their long-term use for low back pain, fibromyalgia, and headaches did not appear to be beneficial. Clinicians should be vigilant for adverse effects and consider deprescribing if pain-related goals are not met.
45
Ahmed, Mohamed Elsammam. "Overcoming the Challenges of Prolonged Ventilation and Critical Illness Polyneuropathy in Severe ARDS Patients Due to Extensive Viral Pneumonia: A Case Report." American Journal of Medical Science and Innovation 2, no. 2 (2023): 192–201. http://dx.doi.org/10.54536/ajmsi.v2i2.2141.
Full textAbstract:
ARDS is a life-threatening condition requiring intensive care unit monitoring. We present a 46-year-old male patient with ARDS and its complications, ventilator-associated pneumonia (VAP) and critcal illness polyneuropathy after extensive bilateral viral pneumonia. The objective of this case report is to understand better and manage the complications of ARDS. This study addresses ARDS and its complications, providing a comprehensive clinical understanding. It details a 46-year-old male patient’s case, treatment strategies, complications, weaning processes, and rehabilitation and emphasises the importance of physical therapy. This case report discusses the successful management and weaning of a patient with extensive viral pneumonia complicated with acute respiratory distress syndrome (ARDS), impending organ dysfunction, and critical illness polyneuropathy. The patient had a medical history of diabetes, hypertension, and dyslipidemia. Initial treatment involved oxygen therapy, nebulization, and empirical antiviral for seasonal flu. However, the patient required invasive ventilation with sedation and muscle relaxants following the ARDSNET protocol due to worsening respiratory status and extensive lung infiltrates. Secondary bacterial infections were also identified and treated accordingly. The weaning process was initiated but was complicated by re-intubation and the development of critical illness polyneuropathy. After successful weaning and recovery from ARDS and associated lung infections, physical therapy was provided for polyneuropathy regularly to overcome the manifest weakness all over the body muscles, including respiratory muscle weakness. The case report highlights the successful management of a patient with viral pneumonia, ARDS, and critical illness polyneuropathy, highlighting the importance of comprehensive treatment and physical therapy.
46
PYLYPENKO, M. M., and B. V. MYKHAYLOV. "JUSTIFICATION FOR THE COMBINED USE OF PROPOFOL AND DEXMEDETOMIDINE IN ELECTIVE PROCEDURAL SEDATION." PAIN, ANAESTHESIA & INTENSIVE CARE, no. 3(96) (September 30, 2021): 9–27. http://dx.doi.org/10.25284/2519-2078.3(96).2021.242135.
Full textAbstract:
Procedural sedation (PS) is the technique of administering sedatives with or without analgesics to induce a condition in which the patient can tolerate unpleasant procedures while maintaining cardio-respiratory function. Planned PSs are performed with procedures of various invasiveness, painfulness and duration, but by definition, they do not reach the depth of general anesthesia and do not require the use of respiratory support or controlled mechanical ventilation, and even more – muscle relaxants. For effective PS, it is extremely important to establish verbal contact with the patient and achieve a stable emotional state of the patient and carefully explain to him the details of the PS. When choosing the depth of PS, it’s necessary to reach a compromise between the degree of anesthesia and amnesia, on the one hand, and the effectiveness of spontaneous breathing, as well as the possibility of an early recovery of consciousness, on the other. If possible, the problem of pain (when consciousness is partially preserved) or nociceptive stimuli (when the level of consciousness is reduced or absent) is solved separately through the use of local or regional anesthesia. In addition, non-steroidal anti-inflammatory drugs (NSAIDs) and some other drugs with analgesic properties are often used, and opioid analgesics are avoided or used in small or minimal doses. Unlike anesthesia, even deep sedation cannot and should not completely prevent the patient from moving during intense pain / nociceptive stimuli. If necessary, the problem of patient movements is solved not only and not so much by further deepening sedation, but precisely by improving analgesia and/or fixing the patient for the duration of short-term painful manipulations. To achieve these goals, PS is most often used propofol, or its dexmedetomidine or midazolam. This publication focuses on the advantages of using a multimodal approach for prolonged PS, which allows for a significant reduction in the dose of corresponding drugs and rate of complications in comparison with sedation with a single anaesthetic at significantly higher doses.
47
Aikaterini, Amaniti, Dalakakis Ioannis, Gkinas Dimitrios, Sapalidis Konstantinos, Grosomanidis Vasilios, and Papazisis George. "Bradycardia Leading to Asystole Following Dexmedetomidine Infusion during Cataract Surgery: Dexmedetomidine-Induced Asystole for Cataract Surgery." Case Reports in Anesthesiology 2018 (December 5, 2018): 1–2. http://dx.doi.org/10.1155/2018/2896032.
Full textAbstract:
Dexmedetomidine is an elective alpha-2 adrenergic agonist, being used in anesthesia practice. It offers sedative, anxiolytic, analgesic, muscle relaxant, and sympathetic lytic properties. While respiratory effects are considered minor, there are important cardiovascular side effects with bradycardia and hypotension being the most common. This article presents a case of a patient, with significant comorbidities and polypharmacy, who was scheduled for cataract surgery under dexmedetomidine sedation. During the administration, severe hemodynamic deterioration was observed with bradycardia and hypotension leading to asystole. Cardiac arrest was successfully managed in accordance with the guidelines of the European Resuscitation Council. Despite the promising role of dexmedetomidine in anesthesia practice, the associated adverse effects cannot be ignored. For this reason it is obligatory to have the minimum mandatory monitoring in accordance with the safety and quality guidelines.
48
Çakirca, Müge, and Devrim Tanil Kurt. "A comparison of the behavioral effects of ketamine and propofol sedation in the pediatric endoscopy unit." Journal of Anesthesia and Critical Care: Open access 15, no. 1 (2023): 42–45. http://dx.doi.org/10.15406/jaccoa.2023.15.00549.
Full textAbstract:
Introduction: Hospitalization and anesthesia can have a harmful psychological impact on children, leading to behavioral abnormalities. Using the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) version of the Post Hospitalization Behavior Questionnaire for daycase patients, the objective of this study is to assess the differences between ketamine and propofol and propofol alone use following anesthesia. Materials and methods: After receiving approval from the ethics committee, 84 children ages 2 to 18 who would undergo sedation surgery at the pediatric endoscopy-colonoscopy unit at Ankara City Hospital were enrolled in the study. Group K consisted of 27 patients sedated with ketamine and propofol, while group P consisted of 57 children sedated with propofol. To detect postoperative behavioral alterations in these youngsters, a questionnaire (POBQ-AS) was administered soon prior to the procedure and on the third day following it. Results: Pre-procedural Behavior Assessment Questionnaire Total scores were comparable for both groups. The measures on the third day following the surgery were also comparable. The Post-procedure Behavior Evaluation Questionnaire Total Score increased significantly (p 0.05) in both groups compared to the pre-procedure score. In Group K, the answers to the questions "Is he disconnected to his environment?" and "Does he become depressed when left alone?" increased significantly more than in the other group (p 0.05). Conclusion: Pediatric perioperative behavioral problem may be common. On the third postoperative day, sedative applications involving ketamine and propofol induce detrimental behavioral alterations, according to this study. In our patient group selected from the endoscopy unit to exclude factors such as mask induction, muscle relaxants, inhalation anesthetics, and surgical incision pain, we believe that only the negative behavioral changes of the intravenous anesthetics ketamine and propofol, as well as factors such as inflammation, surgical stress, and neurotoxicity, should be the focus of future research.
49
Aljohani, Abdullah S. M., Fahad A. Alhumaydhi, Abdur Rauf, Essam M. Hamad, and Umer Rashid. "In Vivo and In Vitro Biological Evaluation and Molecular Docking Studies of Compounds Isolated from Micromeria biflora (Buch. Ham. ex D.Don) Benth." Molecules 27, no. 11 (2022): 3377. http://dx.doi.org/10.3390/molecules27113377.
Full textAbstract:
Micromeria biflora, a traditional medicinal plant, is extensively used for treating various painful conditions, such as nose bleeds, wounds, and sinusitis. A phytochemical investigation of the chloroform fraction of Micromeria biflora led to the isolation of salicylalazine. Salicylalazine was assessed in vivo for analgesia, muscle relaxation, sedative, and anti-inflammatory properties, as well as in vitro for COX-1/2 inhibition activities. It was assessed against a hot plate-induced model at different doses. The muscle relaxant potential of salicylalazine was evaluated in traction and inclined screening models, while sedative properties were determined using an open-field model. The anti-inflammatory potential of salicylalazine was assessed in histamine and carrageenan-induced paw edema screening models. Salicylalazine exhibited significant analgesic potential in a dose-dependent manner. In both screening models, an excellent time-dependent muscle-relaxation effect was observed. Salicylalazine demonstrated excellent sedation at high doses. Its anti-inflammatory activity was determined through the initial and late phases of edema. It exhibited anticancer potential against NCI-H226, HepG2, A498, and MDR2780AD cell lines. In vitro, salicylalazine showed preferential COX-2 inhibition (over COX-1) with an SI value of 4.85. It was less effective in the initial phase, while, in the later phase, it demonstrated significant effects at 15 and 20 mg/kg doses compared with the negative control. Salicylalazine did not exhibit cytotoxicity in the MTT assay, preliminarily indicating its safety.
50
Karateev, A. E., L. I. Alekseeva, I. F. Akhtyamov, et al. "Complex therapy of musculoskeletal pain: the role of centrally acting muscle relaxants." Modern Rheumatology Journal 18, no. 5 (2024): 141–51. http://dx.doi.org/10.14412/1996-7012-2024-5-141-151.
Full textAbstract:
Chronic pain is the main manifestation of musculoskeletal diseases (MSDs), leading to deterioration of quality of life and loss of ability to work. The importance of this problem is determined by the widespread prevalence of MSDs, osteoarthritis (OA), acute and chronic non-specific back pain (NBP), periarticular soft tissues lesions. Introduction of effective methods of treatment of musculoskeletal pain (MSP) into medical practice is one of the fundamental tasks of modern medicine.The pathogenesis of MSP includes mechanisms such as injury, inflammation, peripheral sensitization, biomechanical disorders, dysfunction of the nociceptive system and psychoemotional disorders. Painful muscle tension plays an important role in the development of MSP, especially in NBP. Given the complex pathogenesis of MSP, its treatment is based on the combined use of drugs with different mechanisms of action and nonpharmacological methods. Non-steroidal anti-inflammatory drugs (NSAIDs) have a central place in this context. However, they can cause serious adverse reactions (ARs), so when choosing NSAIDs, it is necessary to consider comorbid pathology and risk factors. One of the most acceptable NSAIDs with a pronounced analgesic effect and low incidence of ARs is aceclofenac, which is available in various dosage forms (tablets, sachets, topical cream for external use). This medication is characterized by proven efficacy and good tolerability.Centrally acting muscle relaxants (CM) play an important role in the treatment of MSP. They eliminate muscle spasm, enhance the effect of analgesics and reduce the need for NSAIDs. The effect of CM has been demonstrated in spasticity and NBP. However, the use of many drugs of this group can be associated with serious ARs, which limits their use.Tolperisone has the best combination of efficacy and favorable safety profile among CM. Its positive effect in the complex treatment of NBP has been confirmed in several well-organized, placebo-controlled trials. There are also studies demonstrating the efficacy of tolperisone in OA. An important advantage of this drug is virtually no sedative effect, and no negative impact on hemodynamics and on the ability to perform concentration-intensive work. Emergence of a new form of tolperisone – extended-release tablets (Mydocalm® Long 450 mg) – increases patient compliance with CM therapy and facilitates the physician's work.