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Related Concept Videos

Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin01:26

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin

Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
The binding of dantrolene to the RYR1...
Depolarizing Blockers: Mechanism of Action01:28

Depolarizing Blockers: Mechanism of Action

Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because succinylcholine...
Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...

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Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
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Published on: September 24, 2020

Desflurane anaesthesia in myotonic dystrophy.

Ranju Gandhi1, Anil Kumar Jain, Jayashree Sood

  • 1Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India.

Indian Journal of Anaesthesia
|March 25, 2011
PubMed
Summary

This study details successful anesthesia management for a myotonic dystrophy (MD) patient undergoing surgery using desflurane. It highlights the importance of careful titration for rapid recovery and reduced complications in MD patients.

Keywords:
Desflurane anaesthesialaparoscopic cholecystectomymyotonic dystrophy

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Area of Science:

  • Anesthesiology
  • Genetics
  • Neuromuscular Disorders

Background:

  • Myotonic dystrophy (MD) is a rare genetic disorder causing progressive muscle weakness and multisystem issues.
  • Anesthesia management in MD patients is challenging due to muscle and systemic involvement, and drug sensitivity.
  • Postoperative respiratory and cardiovascular complications are common in MD patients.

Purpose of the Study:

  • To present the successful anesthetic management of a myotonic dystrophy patient using desflurane.
  • To discuss perioperative considerations for anesthesia in myotonic dystrophy patients.
  • To explore the potential of desflurane-based anesthesia for rapid recovery in MD.

Main Methods:

  • Case report of a myotonic dystrophy patient undergoing laparoscopic cholecystectomy.
  • Utilized a carefully titrated desflurane-based anesthesia technique.
  • Monitored perioperative parameters and patient recovery.

Main Results:

  • Successful completion of laparoscopic cholecystectomy under desflurane anesthesia.
  • Achieved rapid recovery with no significant intraoperative or postoperative complications.
  • Demonstrated the feasibility of desflurane for anesthesia in MD patients.

Conclusions:

  • Desflurane-based anesthesia can be safely and effectively used in myotonic dystrophy patients.
  • Careful titration and perioperative monitoring are crucial for managing MD patients.
  • This approach may facilitate faster postoperative recovery, reducing respiratory risks.