Episode 214: Keywords Part 17: Non-depolarizing blockers and Myesthenic Syndromes

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 214: Keywords Part 17: Non-depolarizing blockers and Myesthenic Syndromes
/

In this 214th episode I welcome back Dr. Gillian Isaac to do another ABA Keyword episode. We review non-depolarizing neuromuscular blockers and myesthenic syndromes.

CME: https://earnc.me/w4WOk8

Show Notes by Dr. Brian H. Park

Random Recs:

Ted Lasso: https://en.wikipedia.org/wiki/Ted_Lasso

Hamnet: Link

Amicus Podcast Interview with Michael Heller: Link

References:

Barash Clinical Anesthesia 8th edition and Anesthesiahub.com

3 Replies to “Episode 214: Keywords Part 17: Non-depolarizing blockers and Myesthenic Syndromes”

  1. In regards to the question about the parturient with MG presenting with Pre-E I believe reason that bupivacaine was the preferred agent rather than 2-Chlorprocaine was because the patient was taking pyridostigmine. Although its primary therapeutic benefit is due to inhibition of acetylcholinesterase, pyridostigmine would also likely reduce the patient’s pseudocholinesterase activity as well. Since 2-chlorprocaine, an ester, is metabolized by pseudocholinesterase this could result in an abnormally prolonged duration of action of 2- chlorprocaine. Bupivicaine metabolism would be unaffected, which would make it the preferred local anesthetic.

    Also, this is probably obvious but I definitely had to remind myself that in this scenario with a patient with likely Pre-E (time allowing of course), a STAT CBC would be certainly beneficial to rule out thrombocytopenia prior to attempting epidural placement.

    Thanks for another great episode, love these keyword reviews!

  2. With regards to the question about which medication does magnesium not prolong, why don’t we see an impact with bupivicaine? I thought since magnesium is an antagonist of calcium and this can result in decreased release of acetylcholine at the synaptic cleft, that it would potentiate the effect of bupivicaine?? I am lost on this one

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.