Search Results (3)

(1) Background: The aim of this bibliometric study is to analyze global research trends, citation impact, and scientific collaborations in the field of neuromuscular blockers (NMBAs) and their antagonists between 2000 and 2024. (2) Methods: Data were retrieved from the Web of Science Core Collection (WoSCC) using Boolean search strategies. Bibliometric analyses were conducted using R bibliometrix, VOSviewer, and CiteSpace software to visualize collaboration networks, keyword trends, and citation bursts. (3) Results: A total of 499 articles were analyzed, with the United States of America (USA), China, and South Korea leading in productivity, while France had the highest citation impact. Influential authors included Mertes PM and Fuchs-Buder T. Emerging topics such as sugammadex, sevoflurane, and neuromuscular monitoring were identified, reflecting a shift from pharmacokinetic studies to safety and monitoring strategies. (4) Conclusions: The findings indicate a marked increase in studies on neuromuscular monitoring and reversal agents, such as sugammadex, over the past two decades. The USA, France, and China emerged as the most contributory countries in NMBAs research, with their extensive international collaborations playing a pivotal role in shaping scientific progress. Highly influential studies have predominantly focused on NMBA pharmacokinetics, safety, anaphylaxis risks, and the clinical benefits of sugammadex, underscoring its critical role in reducing residual neuromuscular blockade (rNMB) and enhancing patient safety. Full article

This Critical Appraisal aims to explore the pharmacokinetics and pharmacodynamics of medications used in organ donors after euthanasia (ODE) and their impact on abdominal organ quality. With the legalization of ODE, the donor pool has expanded, but it has introduced complexities regarding organ quality. This study evaluates existing euthanasia protocols in the Netherlands, Belgium, Spain, and Canada, focusing on differences in the medication types and dosages. Additionally, a literature review assessed the potential hepatotoxic effects of high-dose medications like thiopental, propofol, and non-depolarizing neuromuscular blocking agents. High doses of non-depolarizing neuromuscular blocking agents, particularly rocuronium, are associated with hepatotoxic effects in vitro. Furthermore, thiopental doses exceeding 750 mg significantly increase the risk of liver dysfunction. Recent findings also indicate that high-dose propofol and lidocaine can slightly prolong the time to death, which is crucial for optimizing organ viability in ODE. This study highlights the need to optimize organ donation procedures after euthanasia. Further research is needed to achieve this balance, maintaining the integrity and ethical standards of the euthanasia process while enhancing the outcomes of organ donation. Full article

(1) Background: Pancuronium bromide is a neuromuscular blocker used for immobilizing crocodiles that can be reversed with neostigmine. A recommended drug dose has only been established for saltwater crocodiles (Crocodylus porosus), mostly based on trials in juveniles and subadults. After trialing a dose recommendation in a small cohort of nine Nile crocodiles (Crocodylus niloticus), we developed and applied a new dose recommendation for large adult Nile crocodiles. (2) Methods: we trialed and adapted a pancuronium bromide (Pavulon 4 mg/2 mL) dose in Nile crocodiles originally established for saltwater crocodiles and applied the new dose for the immobilization of 32 Nile crocodiles destined for transport. Reversal was achieved with neostigmine (Stigmine 0.5 mg/mL). (3) Results: Nine crocodiles were included in the trial phase; the induction time was highly variable (average: 70 min; range: 20–143 min), and the recovery time was prolonged (average: 22 h; range: 50 min–5 days), especially in large animals after reversal with neostigmine. Based on these results, we established a dose-independent recommendation (3 mg pancuronium bromide and 2.5 mg neostigmine) for animals weighing ≥ 270 kg (TL ≥ ~3.8 m). When applied to 32 adult male crocodiles (BW range: 270–460 kg; TL range: 3.76–4.48 m), the shortest induction time was ~20 min and the longest ~45 min. (4) Conclusions: Pancuronium bromide and its antidote, neostigmine, are effective for the immobilization and reversal of adult male Nile crocodiles (TL ≥ 3.8 m or BW ≥ 270 kg) when given in a weight-independent fashion. Full article