Author/Editor     Požar-Lukanović, Neva; Grad, Irena; Lukanović, Nina; Kompan, Janez
Title     Novi pogledi na mišično relaksacijo pri endoskopskih posegih
Translated title     Recent views on muscle relaxation during endoscopic procedures
Type     članek
Source     Endoskopska revija
Vol. and No.     Letnik 16, št. 33
Publication year     2011
Volume     str. 29-34
Language     slo
Abstract     Pneumoperitoneum formation during laparoscopic procedures affords good visibility and enough space for surgery. However, it exerts adverse effects on the patient's respiration and circulation. A special risk is posed by excessive intraabdominal pressure, which may be caused, among other things, by insufficient relaxation of abdominal wall and diaphragm. Therefore, monitoring of the level of neuromuscular block (NMB) is required. Accelerometry is a clinically appropriate method for NMB monitoring. At the end of the operation, NMB must be reversed in order to prevent serious complications that may result from residual relaxation. Traditional drugs for NMB reversal are inhibitors of enzyme acetyl-choline esterase (AchE), which are relatively inefficient. They are slow acting, cause adverse effects and do not act on deep NMB. A specific ligand of aminosteroid muscular relaxants sugammadex is a promising drug, that reverses NMB immediately, regardless of its depth, and has no adverse side-effects. It allows for appropriate NMB depth required for laparoscopic surgery and minimizes the risk of postoperative residual relaxation.
Descriptors     LAPAROSCOPY
PNEUMOPERITONEUM, ARTIFICIAL
ANESTHESIA
NEUROMUSCULAR BLOCKADE
MUSCLE RELAXATION
CHOLINESTERASE INHIBITORS