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rocuronium onset during general anesthesia in a patient on long-term anticonvulsant therapy because of intractable epilepsy. Written consent was obtained from the patient’s legal guardian to publish the details of this case report. CASE PRESENTATION A 33-year-old man (height, 150 cm [59 in]; weight, 30 kg; body mass index, 13.3 kg/m 2 ) was scheduled for extraction of all 4 third molars and restorative treatment for dental caries. He was delivered at 37 weeks gestation with no perinatal abnormalities. However, 3 days after delivery, he contracted bacterial meningitis

anticonvulsant currently indicated by the Food and Drug Administration for add-on use in treating partial seizures. 16 17 Gamma-aminobutyric acid is the main central nervous system inhibitory neurotransmitter. After release into the synaptic cleft, it is taken back up into the neuron and nearby glia by several pumps specific to gamma-aminobutyric acid, one of which is termed GAT-1. 18 Tiagabine specifically inhibits GAT-1. 16–18 The adverse-effect profile of tiagabine is usually benign, with daytime tiredness being the most common effect. The only serious concern is rare

Advanced cardiac life support, 162 Air-pressure sensor, 100 Airway evaluation, 74 Airway management, 74, 166 Alpha-2 agonists, 31 Ambulatory, 168 AMSA injection, 153 Analgesia, 57 Anaphylactoid reaction, 64 Anaphylaxis, 22 Anesthesia, 74 Anesthetic, 140 Anticonvulsants, 8 Apert syndrome, 122 Assessment, 140 Atrial septal defect, 125 Barbituric acid, 8 Benzodiazepines, 8 Bore size, 2 Cardiac

anticonvulsants during acute phases of mania, and with antidepressants for complex cases of depression. Most agents are excellent antiemetics and can be used to manage nausea and vomiting. Finally, their sedative effects can be used to potentiate sedatives and opioids during anesthesia and pain management. Most of the first-generation antipsychotic drugs are derivatives of the phenothiazine molecular structure, although haloperidol (Haldol) is a notable exception derived from a butyrophenone. For this reason, it is not uncommon for antipsychotics to be referred to as

-old woman with a height of 164 cm, a weight of 105 kg, and a body mass index of 39 kg/m 2 . She was diagnosed with tuberous sclerosis at the age of 6 months and developed epilepsy with tonic seizures. She had been prescribed anticonvulsants since childhood and was currently taking valproate, zonisamide, and topiramate. Because of persistent daily epileptic seizures, she underwent placement of a VNS device under general anesthesia at 26 years of age, after which the frequency of her seizures initially decreased to once every few months. However, her epilepsy gradually

postoperative nausea and vomiting. To exploit the anticonvulsant properties of propofol, sevoflurane was discontinued and infusion of propofol started 90 minutes before the end of the procedure at a rate of 100 mcg/kg/min. It was titrated down to 40 mcg/kg/min 30 minutes before the procedure ended, then was terminated 10 minutes before completion. Total duration of the procedure was 2 hours 40 minutes. The trachea was extubated once criteria were met. The patient did well, maintaining adequate tidal volume, respiration rate, and oxygen saturation first with

pathway; the use of anticonvulsants for shooting pain; paroxysmal neuropathic pain—the analgesic mechanism attributed to blockade of sodium channels, which decreases spontaneous depolarization (carbamazepine and phenytoin); and an increase in GABAergic transmission (valproic acid and clonazepam). Other agents that are discussed include the full gamut of nonsteroidal anti-inflammatories and tricyclic antidepressants (particularly indicated for constant, burning pain). Their mechanism in this regard appears to be attributed to sodium channel blockade as well as blockade

, gastric secretion inhibitors, antacids, antiemetics, and anticholinergics and rapid sequence induction may be considered. 7 , 8 For a patient with an extremely high risk of aspiration, Nissen fundoplication may be performed. Seizures may occur in severe cases. 3 To detect their occurrence early and to treat them appropriately, it is important to evaluate the type of epilepsy during the preoperative examination. The side effects of anticonvulsant drugs and possible interactions with drugs used for anesthesia should also be considered. General anesthetics have

The action of muscle relaxants is affected by a variety of drugs. Ephedrine shortens onset time, while β-receptor blocker prolongs it. 1 Aminoglycoside antibiotics, 2 calcium channel blockers, and magnesium sulphate prolong duration, 3 , 4 whereas anticonvulsant drugs including carbamazepine shorten it. 5 Propitocaine, lidocaine, and other local anesthetics prolong duration, 6 while epinephrine produces dual effects of antagonizing neuromuscular relaxation through α-adrenergic effects and enhancing neuromuscular relaxation through β-adrenergic effects