Article of the Month – July 2022 – Richard Prielipp, Manfred Blobner and Ken Johnson
Highlights
- Zero Point Nine?
Summary:
The traditional trainof for ratio greater than point seven was established a long time ago on data from healthy volunteers. And these volunteers likely had adequate strength. They had good, sufficient reserve with normal insetory force and normal vital capacity to tolerate a little bit of residual blockade. What's the real evidence that the elimination of residual weakness requires a ratio greater than zero point nine? Zero? Well, thank you for that question. Perhaps doctor blober can speak to this better than i,. But here are some quick thoughts.
Transcript:
Speaker 3
Senior clinitions will recall that traditional training suggested that a train for ratio greater than zero point seven was adequate to indicate appropriate neuro muscular recovery. What has led to the change to today's recommendation of zero point nine? And what's the real evidence that the elimination of residual weakness requires a ratio greater than zero point nine? Zero?
Speaker 1
Well, thank you for that question. Perhaps doctor blober can speak to this better than i, but here are a few quick thoughts. The traditional trainof for ratio greater than point seven was established a long time ago on data from healthy volunteers. And these volunteers likely had adequate strength. They had good, sufficient reserve with normal insetory force and normal vital capacity to tolerate a little bit of residual blockade. (Time 0:06:42)
- Reversal of Nermos Blockade With Ne Stigma
Summary:
numers blockade is used here in the united states in about 19 % of all surgical procedures. 80% of those with, as you mentioned, rock eronium or vecuronium. So sgamanexis ging t work most of the time. Of course, the exceptions are when sisaticuriumis used. Data from a large retrospective analysis comparing reversal of nermos blockade with ne stigma in sgamete found a 30 % decrease in the incidents of adverse pulmonary events when using sugamanx.
Transcript:
Speaker 1
Based on published work, numers blockade is used here in the united states in about 19 % of all surgical procedures, 80 % of those with, as you mentioned, rock eronium or vecuronium. So sgamanexis ging t work most of the time. Of course, the exceptions are when sisaticuriumis used. Data from a large retrospective analysis comparing reversal of nermos blockade with ne stigma in sgamete found a 30 % decrease in the incidents of adverse pulmonary events when using sugamanx. And i would encourage listeners to take a look at the stronger study which reports this data. An these rpetors use rock we ar amin vacuria. Most of the time. These drugs are easily and effectively reversed with scametics, obviating the need for quantitative monitring. Another concern is that when reversing patients from deep or profound nermous bake, there is a risk of recuriation. A systematic review and medoanalysis of our (Time 0:14:36)
- The Cost Effectiveness of Sugama Dek
Summary:
Do good cost effectiveness studies exist regarding the acquisition and routine use of these new quantitative monitors? And is recuraization after two millograms per kilogram of sugamedaks a real or imaginary threat to the recovery of our patients? There are data that show that especially obese patients and patience with a high body fat are at risk for recrisation.
Transcript:
Speaker 3
Doctor blabner, do good cost effectiveness studies exist regarding the acquisition and routine use of these new quantitative monitors? And is recuraization after two millograms per kilogram of sugamedaks a real or imaginary threat to the recovery of our patients?
Speaker 2
Your second point, there are data that show that especially obese patients and patience with a high body fat are at risk for recrisation, at least when sugama dek is dosed according to ideal body weight and not to real bodyweight. (Time 0:22:55)
- Quantitative Monitoring Is a Significant Improvement Over Qualitative Monitoring
Summary:
The eye muscles, thebiculars orus and corrugatod supercili, are not sensitive enough te fool us. As with other technologies introduced into the pereoperative work space, it's premature to claim that quantitative monitoring is a significant improvement over qualitative. The first bench mark truly bench marked the performance of properly used quantitative monitoring.
Transcript:
Speaker 1
Yes. Thank you. First off, i'd like to just say that it was indeed an honor to debate this with doctor mamford wabner. His listeners may know, he has dedicated a significant amount of his career to the study of normous blockade, normasplacade monitoring, and is is highly regarded as an expert on this topic. So appreciate that. A few comments. As with other technologies introduced into the pereoperative work space, it's premature to claim that quantitative monitoring is a significant improvement over qualitative to establish the superiority of quantitative monering, it's reasonable the first bench mark truly bench marked the performance of properly used qualitative monitoring. And what do yiu mean by that? Well, the first step is to always measure at the wrist and not the eye, meaning the abductor polysis, or the first dorsal inerasis, or the abductor digitie minimi. The eye muscles, thebiculars orus and corrugatod supercili, are not sensitive enough te fool us. Twitches return too quickly. Thing for the diaphragm. (Time 0:24:54)
Article of the Month – July 2022 – Richard Prielipp, Manfred Blobner and Ken Johnson
Highlights
- Zero Point Nine?
Summary:
The traditional trainof for ratio greater than point seven was established a long time ago on data from healthy volunteers. And these volunteers likely had adequate strength. They had good, sufficient reserve with normal insetory force and normal vital capacity to tolerate a little bit of residual blockade. What's the real evidence that the elimination of residual weakness requires a ratio greater than zero point nine? Zero? Well, thank you for that question. Perhaps doctor blober can speak to this better than i,. But here are some quick thoughts.
Transcript:
Speaker 3
Senior clinitions will recall that traditional training suggested that a train for ratio greater than zero point seven was adequate to indicate appropriate neuro muscular recovery. What has led to the change to today's recommendation of zero point nine? And what's the real evidence that the elimination of residual weakness requires a ratio greater than zero point nine? Zero?
Speaker 1
Well, thank you for that question. Perhaps doctor blober can speak to this better than i, but here are a few quick thoughts. The traditional trainof for ratio greater than point seven was established a long time ago on data from healthy volunteers. And these volunteers likely had adequate strength. They had good, sufficient reserve with normal insetory force and normal vital capacity to tolerate a little bit of residual blockade. (Time 0:06:42)
- Reversal of Nermos Blockade With Ne Stigma
Summary:
numers blockade is used here in the united states in about 19 % of all surgical procedures. 80% of those with, as you mentioned, rock eronium or vecuronium. So sgamanexis ging t work most of the time. Of course, the exceptions are when sisaticuriumis used. Data from a large retrospective analysis comparing reversal of nermos blockade with ne stigma in sgamete found a 30 % decrease in the incidents of adverse pulmonary events when using sugamanx.
Transcript:
Speaker 1
Based on published work, numers blockade is used here in the united states in about 19 % of all surgical procedures, 80 % of those with, as you mentioned, rock eronium or vecuronium. So sgamanexis ging t work most of the time. Of course, the exceptions are when sisaticuriumis used. Data from a large retrospective analysis comparing reversal of nermos blockade with ne stigma in sgamete found a 30 % decrease in the incidents of adverse pulmonary events when using sugamanx. And i would encourage listeners to take a look at the stronger study which reports this data. An these rpetors use rock we ar amin vacuria. Most of the time. These drugs are easily and effectively reversed with scametics, obviating the need for quantitative monitring. Another concern is that when reversing patients from deep or profound nermous bake, there is a risk of recuriation. A systematic review and medoanalysis of our (Time 0:14:36)
- The Cost Effectiveness of Sugama Dek
Summary:
Do good cost effectiveness studies exist regarding the acquisition and routine use of these new quantitative monitors? And is recuraization after two millograms per kilogram of sugamedaks a real or imaginary threat to the recovery of our patients? There are data that show that especially obese patients and patience with a high body fat are at risk for recrisation.
Transcript:
Speaker 3
Doctor blabner, do good cost effectiveness studies exist regarding the acquisition and routine use of these new quantitative monitors? And is recuraization after two millograms per kilogram of sugamedaks a real or imaginary threat to the recovery of our patients?
Speaker 2
Your second point, there are data that show that especially obese patients and patience with a high body fat are at risk for recrisation, at least when sugama dek is dosed according to ideal body weight and not to real bodyweight. (Time 0:22:55)
- Quantitative Monitoring Is a Significant Improvement Over Qualitative Monitoring
Summary:
The eye muscles, thebiculars orus and corrugatod supercili, are not sensitive enough te fool us. As with other technologies introduced into the pereoperative work space, it's premature to claim that quantitative monitoring is a significant improvement over qualitative. The first bench mark truly bench marked the performance of properly used quantitative monitoring.
Transcript:
Speaker 1
Yes. Thank you. First off, i'd like to just say that it was indeed an honor to debate this with doctor mamford wabner. His listeners may know, he has dedicated a significant amount of his career to the study of normous blockade, normasplacade monitoring, and is is highly regarded as an expert on this topic. So appreciate that. A few comments. As with other technologies introduced into the pereoperative work space, it's premature to claim that quantitative monitoring is a significant improvement over qualitative to establish the superiority of quantitative monering, it's reasonable the first bench mark truly bench marked the performance of properly used qualitative monitoring. And what do yiu mean by that? Well, the first step is to always measure at the wrist and not the eye, meaning the abductor polysis, or the first dorsal inerasis, or the abductor digitie minimi. The eye muscles, thebiculars orus and corrugatod supercili, are not sensitive enough te fool us. Twitches return too quickly. Thing for the diaphragm. (Time 0:24:54)