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Comparison of two pharmacokinetic–pharmacodynamic models of rocuronium bromide ...

Couto, Mafalda; Vide, Sérgio; Marco-Ariño, Nicolás; Troconiz, Iñaki F.; Esteves, Simão; Nunes, Catarina S.; Amorim, Pedro; Mendes, Joaquim

Background: Profound neuromuscular block (NMB) is important in surgeries where complete immobility is considered essential to improve tracheal intubation and surgical conditions. Rocuronium bromide is a commonly used NMB agent. This work describes a noninvasive approach for estimation of post-tetanic count (PTC) based on two pharmacokinetic (PK) models, the Saldien and the De Haes models. The aim was to investi...


Systematic review on Rocuronium continuous infusion for deep neuromuscular bloc...

Couto, Mafalda; Couto, J. Guilherme; Nunes, Catarina S.; Vide, Sérgio; Amorim, Pedro; Mendes, Joaquim

Background: Rocuronium is a muscle relaxant with increased use due to its binding relation with the reversal agent sugammadex. The purpose of this review entails the investigation of its use for the maintenance of Deep Neuromuscular Block (NMB) via continuous infusion. Methods: Based on PRISMA systematic search guidelines, databases included PubMed, ISI Web of Science, Cochrane Library and Google Scholar. This ...


Implementation of neural networks to frontal electroencephalography for the ide...

Ferreira, Ana Isabel Leitão; Vide, Sérgio; Nunes, Catarina S.; Neto, Joaquim; Amorim, Pedro; Mendes, Joaquim

Objective: General anesthesia is a reversible drug-induced state of altered arousal characterized by loss of responsiveness (LOR) due to brainstem inactivation. Precise identification of the LOR during the induction of general anesthesia is extremely important to provide personalized information on anesthetic requirements and could help maintain an adequate level of anesthesia throughout surgery, ensuring safe ...


Performance of blink reflex in patients during anesthesia induction with propof...

Ferreira, Ana Leitão; Nunes, Catarina S; Vide, Sérgio; Felgueiras, João; Cardoso, Márcio; Amorim, Pedro; Mendes, Joaquim

Background: The amount of propofol needed to induce loss of responsiveness varied widely among patients, and they usually required less than the initial dose recommended by the drug package inserts. Identifying precisely the moment of loss of responsiveness will determine the amount of propofol each patient needs. Currently, methods to decide the exact moment of loss of responsiveness are based on subjective an...


Performance of blink reflex in patients during anesthesia induction with propof...

Ferreira, Ana Isabel Leitão; Vide, Sérgio; Felgueiras, João; Cardoso, Márcio; Amorim, Pedro; Mendes, Joaquim; Nunes, Catarina S.

The amount of propofol needed to induce loss of responsiveness varied widely among patients, and they usually required less than the initial dose recommended by the drug package inserts. Identifying precisely the moment of loss of responsiveness will determine the amount of propofol each patient needs. Currently, methods to decide the exact moment of loss of responsiveness are based on subjective analysis, and ...


Electromyographic assessment of blink reflex throughout the transition from res...

Ferreira, Ana Isabel Leitão; Vide, Sérgio; Felgueiras, João; Cardoso, Márcio; Nunes, Catarina S.; Mendes, Joaquim; Amorim, Pedro

General anesthesia is a reversible drug-induced state of altered arousal characterized by loss of responsiveness due to brainstem inactivation. Precise identification of the moment in which responsiveness is lost during the induction of general anesthesia is extremely important to provide information regarding an individual's anesthetic requirements and help intraoperative drug titration. To characterize the tr...


Foreseeing postoperative pain in neurosurgical patients: pupillometry predicts ...

Vide, Sérgio; Castro, Ana; Correia, Rui; Cabral, Tiago; Lima, Deolinda; Nunes, Catarina S.; Gambús, Pedro; Amorim, Pedro

Pupillary reflex dilation (PRD) is triggered by noxious stimuli and diminished by opioid administration. In the postoperative period, PRD has been shown to be correlated with pain reporting and a useful tool to guide opioid administration. In this study we assessed whether pupillary measurements taken before extubation were related with the patient's reported pain in the Post-Anesthesia Care Unit (PACU) using t...


Patterns of hysteresis between induction and emergence of neuroanesthesia are p...

Ferreira, Ana Isabel Leitão; Correia, Rui; Vide, Sérgio; Ferreira, Ana Dias; Kelz, Max B.; Mendes, Joaquim; Nunes, Catarina S.; Amorim, Pedro

Recovery of consciousness is usually seen as a passive process, with emergence from anesthesia depicted as the inverse process of induction resulting from the elimination of anesthetic drugs from their central nervous system sites of action. However, that need not be the case. Recently it has been argued that we might encounter hysteresis to changes in the state of consciousness, known as neural inertia. This p...



Rocuronium continuous infusion for profound neuromuscular blockade: a systemati...

Couto, Mafalda; Nunes, Catarina S.; Vide, Sérgio; Amorim, Pedro; Mendes, Joaquim

Rocuronium is a muscle relaxant with increased use, because of the binding relation with the reversal agent sugammadex. Its continuous infusion benefits the maintenance of deeper levels of neuromuscular blockade (NMB) ensuring an improved and stable solution for daily surgical anesthesia. This is systematic review on current approaches on rocuronium infusion and monitoring parameters when using rocuronium conti...


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