Anesthesia

[cmonkey]

I was just reading the thread about why patients are to void before a surgery, and I saw a mention of paralytics. Are they used in most surgeries with general anesthesia, or is it case by case? Why would it be used in one situation and not another? It never occured to me that one could have surgery without it, I guess. Or maybe I just thought the sedation was enough to essentially *cause* paralysis during the operation. Hm.

Anyway, what's the deal with anesthesia?

[GilaRRT]

The context was with rocuronium, so the concern.

I think sugammadex has the potential to be great addition for difficult airway management, not so much for routine muscle paralysis. It would be nice to give a 1.2 mg/kg dose of Zem, get a nice quick relaxation (approaching sux) and then have the option of quick reversal in the Can't intubate Can't ventilate case. It's too expensive to use for routine management. As for side effects, not many drugs have as many serious SE as sux does. It probably wouldn't get through the FDA today.

If you have a link, I would love to read the source.

I agree that sux is associated with many side effects, especially in my area of the world where every other person is a non-compliant chronic renal failure patient who has skipped out on their last three dialysis sessions. In spite of the few reported sugammedex side effects, I cannot see how it can be any worse than reversal with current methods; neostigmine, followed by atropine to manage the adverse effects of the neo, followed by hoping for no other side effects.

It's nice to actually have a technical discussion in the CRNA forum.

[cmonkey]

It is being used in Europe, however. We can only hope they continue to have good experiences with sugammadex and it obtains FDA approval. However, IV paracetamol has been used safely and with success for what, 20 years in Europe, and we still do not use it in the United States?

Paracetamol is acetaminophen, isn't it? I had no idea you could even give that IV. Is that just for pain relief, or is it another use entirely?

recurarization. This means?