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Mechanisms and implications in gene polymorphism mediated diverse reponses to sedatives, analgesics and muscle relaxants

Sun Y, Zhu H, Esmaeili E, Tang X, Wu Z

Responses to sedatives, analgesics and muscle relaxants vary among patients under general anesthesia, which could be ascribed to the disparities of clinical characteristics and genetic factors of individuals. Accumulating researches...
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Neuromuscular blocking agents and opioids are major risk factors for developing pressure injuries in patients in the intensive care unit

Lee SY, Oh DK, Hong SB, Lim CM, Huh JW

Background/Aims: Patients in the intensive care unit (ICU) are at high risk for developing pressure injuries, which can cause severe complications and even increase the mortality risk. Therefore, prevention of...
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Factors Associated with the Underuse of Sedatives and Neuromuscular Blocking Agents for Pediatric Emergency Endotracheal Intubation in Korea

Lee JY, Lee SU, Son MH, Park JW, Jung JY, Kim JH

Purpose: Rapid sequence intubation (RSI) using sedatives and neuromuscular blocking agents (NMBAs) is recommended for pediatric emergency endotracheal intubation (ETI), but is not frequently performed in Korea. This study aimed...
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Choice of neuromuscular block reversal agent to reduce postoperative pulmonary complications

Cho SA, Sung TY

The definition of postoperative pulmonary complications (PPCs) is inconsistent in literature; however, PPCs include pulmonary abnormalities that adversely affect patient outcomes, such as respiratory failure, atelectasis, pneumonia, pleural effusion, and...
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Effects of hydrocortisone-presensitized sugammadex on recovery from neuromuscular blockade induced by rocuronium: a rodent in vivo study

Choi HR, Yang HS, Choi JM, Park C, In J, Kim YB

Background: Sugammadex is a specific antagonist of aminosteroidal neuromuscular blocking agents with 1:1 binding to guest molecules. Sugammadex can also bind to other drugs having a steroid component in its...
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Neuromuscular blockade management in patients with COVID-19

Chaves-Cardona H, Hernandez-Torres V, Kiley S, Renew J

This narrative review evaluates the evidence for using neuromuscular blocking agents (NMBA) in patients being treated for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While large prospective randomized-controlled trials (RCTs)...
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The latest trend in neuromuscular monitoring: return of the electromyography

Lee W

To reduce the risk of residual neuromuscular blockade, neuromuscular monitoring must be performed. Acceleromyography (AMG)-based neuromuscular monitoring was regarded as “clinical gold standard” and widely applied. However, issues related to...
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General Anesthesia for a Patient with GNEMyopathy: a case report

Kang C, An Jh, Kwon JY, Hwang BY

GNE, or bifunctional UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase, myopathy presents with symptoms of foot drop, followed by lower and upper extremity muscle weaknesses and sparing of the quadriceps. Myopathies usually increase the...
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Airway anesthesia with lidocaine for general anesthesia without using neuromuscular blocking agents in a patient with a history of anaphylaxis to rocuronium: a case report

Ji SM, Song J, Choi G

We experienced a case of induction of general anesthesia without using neuromuscular blocking agents (NMBAs) in a 40-year-old woman with a history of anaphylaxis immediately after the administration of anesthetics...
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Effects of different sugammadex doses on the train of four ratio recovery progression during rocuronium induced neuromuscular blockade in the rat phrenic nerve hemidiaphragm

Kim YB, Choi JM, Chang YJ, Choi HR, In J, Yang HS

Background: In this study, we used an ex-vivo model to investigate the recovery pattern of both the train-of-four (TOF) ratio and first twitch tension of TOF (T1), and determined their...
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Current use of neuromuscular blocking agents and antagonists in Korea: a 2018 survey

Kim JS, Han JW, Lee JH, Choi JM, Kim HJ, Sung TY, Kim YB, Shin YS, Yang HS

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...
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Risk factors associated with inpatient cardiac arrest during emergency endotracheal intubation at general wards

Park C

BACKGROUND: Peri-intubation cardiac arrest (PICA) following emergent endotracheal intubation (ETI) is a rare, however, potentially preventable type of cardiac arrest. Limited published data have described factors associated with inpatient PICA...
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Intradermal skin tests for rocuronium and cisatracurium in patients with a history of allergy: a retrospective study

Kim YY, Kim IT, Shin SI, Yim SM

BACKGROUND: Neuromuscular blocking agents (NMBAs) are a leading cause of perioperative anaphylaxis. However, the performance of systematic screening skin tests to detect reactions for NMBAs prior to general anesthesia is...
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Updated review of resistance to neuromuscular blocking agents

Jung KT, An TH

Since neuromuscular blocking agents (NMBAs) were introduced to the surgical field, they have become almost mandatory for the induction and maintenance of anesthesia. However, resistance to NMBAs can develop in...
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Use of remifentanil and propofol without muscle relaxant with Duchenne muscular dystrophy: A case report

Kim HS, Baek SY, Park DH, Ryu KH

Duchenne muscular dystrophy (DMD) is a relatively rare muscle disease with severe symptoms. Owing to the commonly limited mouth opening, cervical spine immobility, and deformation, DMD patients often present with...
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Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents

Kim YB, Sung TY, Yang HS

Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric...
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Late recurarization in the post-anesthetic care unit after total thyroidectomy: A case report

Kim DW, Kim BK, Kim JW, Kim JD, Ryu SJ, Kim DS

Residual paralysis, recurarization is defined as a remnant effect of neuromuscular blocking after surgery that can cause postoperative complications. Clinical complications of recurarization include dyspnea, gastric content aspiration, and atelectasis....
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Change in the effect of rocuronium after pneumatic tourniquet release in patients undergoing unilateral total knee arthroplasty

Seo H, Koh WU, Baik J, Ro YJ, Yang HS

BACKGROUND: A pneumatic tourniquet is commonly used in orthopedic surgery. However, neuromuscular blocking agent can be sequestered in the isolated limb and be reabsorbed into the systemic circulation after tourniquet...
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Pholcodine consumption and immunoglobulin E-sensitization in atopics from Australia, Korea, and Japan

Katelaris , Kurosawa M, Moon HB, Borres M, Florvaag E, Johansson

BACKGROUND: Accumulating data indicates that pholcodine (PHO)-consuming countries have higher sero-prevalences of immunoglobulin E (IgE)-antibodies to PHO and suxamethonium (SUX) and increased frequencies of IgE-mediated anaphylaxis to neuromuscular blocking agents...
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Anaphylactic reactions after cisatracurium administration in two patients: a report of two cases

Yoon Y, Lee B, Seo HS, Bang J, Ha SI, Song JG

Cisatracurium was initially characterized to have no evident histamine-releasing potential with excellent cardiovascular stability. However, severe anaphylactic reactions to cisatracurium that resulted in bronchospasms and cardiovascular collapse have been reported...
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