Biomedical subjects

J-U Schreiber

Publications and source records attributed to J-U Schreiber.

3 recordsLinked to original sources

PubMed2006

Does preoperatively administered parecoxib prevent succinylcholine-associated myalgia? A randomized, placebo-controlled trial.

BACKGROUND AND OBJECTIVE: Data from several studies implicate that pre-treatment with non-selective cyclooxygenase inhibitors such as aspirin or diclofenac may decrease the incidence of postoperative succinycholine-related myalgia. We tested the influence of a preoperatively administered selective cyclooxygenase 2 inhibitor, parecoxib, on postoperative myalgia. METHODS: After Ethics Committee approval, 68 patients were randomized into two groups (n = 34 each). Group 1 received parecoxib 40 mg intravenously 3 min before induction of anaesthesia, and Group 2 received saline (in a double-blinded manner). Incidence and severity of myalgia was evaluated systematically with a standardized questionnaire 24, 48 and 72 h after anaesthesia. We also the assessed the number of patients who felt limited in their activity due to myalgia. RESULTS: Seven patients in the parecoxib-treated group complained of myalgia compared with 11 in the control group (not significant). No significant difference in the severity of myalgia or in the limitation of patients activity was found between the groups. CONCLUSION: Intravenous parecoxib 40 mg, when administered before induction of anaesthesia, did not reduce incidence and severity of postoperative myalgia and did not improve activity in those who suffered from myalgia.

Adult↗

PubMed2006

[Neuromuscular blockades. Agents, monitoring and antagonism].

Currently, the main aims of using neuromuscular blocking agents during general anaesthesia are the improvement of surgical and intubation conditions. Neuromuscular blocking agents themselves are neither analgesic nor anaesthetic. All agents interact with the acetylcholinergic receptor at the neuromuscular junction and induce a blockade either through a continuous activation imitating the effect of acetylcholine or through a competitive antagonism against acetylcholine. Succinylcholine is the only depolarizing muscle relaxant that is in clinical use. Non-depolarizing neuromuscular blockers may be grouped by their chemical structure into benzylisoquinolines or aminosteroids, and cover the complete range from short and intermediate, to long acting agents. Possible adverse drug reactions to the single agents are also related to their mechanism of action. Moreover, pharmacokinetic properties and effects such as histamine liberation could play an important role when choosing a myorelaxant. The depth of a neuromuscular block and recovery from paralysis can be monitored using qualitative and quantitative techniques. Therefore, the monitoring of neuromuscular recovery plays an important role in the prevention of postoperative complications due to residual paralysis. In case of residual paralysis, cholinesterase inhibitors are suitable for reversal.

Anesthesia↗

PubMed2005

[Influence of gender on the intubation conditions with rocuronium].

PURPOSE: There is increasing evidence for gender differences in the pharmacokinetics and pharmacodynamics of anaesthetic drugs and neuromuscular blocking agents, e.g. rocuronium (Roc). Females require 30% less Roc than males to achieve the same degree of neuromuscular block and onset times are shorter. However, whether this leads to an improvement of the intubation conditions in females is unclear. METHODS: After approval of the ethics committee 60 female and 60 male patients were each randomised into 2 groups to receive 0.6 mg/kg body weight Roc or 1.0 mg/kg succinylcholine (Sux; control group). Induction: thiopentone (5 mg/kg), fentanyl (3 microg/kg) then Roc (Roc groups) or Sux (Sux groups) and tracheal intubation after 60 s. Time to intubation, glottic exposure and intubating conditions were assessed. RESULTS: Men were significantly larger and heavier (p<0.001) than women, but the body mass index was comparable (ns). Number of attempts, time to intubation, and Cormack grades were comparable (ns). However, the rate of clinically acceptable intubation conditions was significantly higher in the female compared to the male Roc group: 80% vs 47%, p<0.05. The incidence of clinically acceptable intubation conditions in the female Roc and Sux groups were similar (80%). CONCLUSION: The intubation conditions after Roc were significantly better in women than in men. The differences were Roc-related and did not occur in the control groups.

Adult↗