Thymoma, which can be surgically treated under general anaesthesia, is associated with the patho physiology of myasthenia gravis. Muscle weakness is a hallmark of myasthenia gravis; therefore, these patients are hypersensitive to the effects of non-depolarising muscle relaxants. Neuromuscular blockers can cause prolonged postoperative muscle relaxation, leading to decreased respiratory function. Therefore, careful administration of muscle relaxants during the peri operative period is important. The neuromuscular antagonist, sugammadex, has been used to counteract problems associated with muscle relaxants. By encapsulating non-depolarising muscle relaxants, sugammadex can reverse the neuromuscular blockade. In this study, the authors report three cases of myasthenia gravis. In each case, peri operative management included use of a train-of-four (TOF) monitor to minimise muscle relaxant use during surgery. Sugammadex was administered postoperatively, was safe for use in patients with myasthenia gravis and may effectively reduce the risk of postoperative respiratory complications.
Authors: Shingu, Chihiro; Nishida, Taichi; Hagiwara, Satoshi; Shiihara, Keisuke; Oyama, Yoshimasa; Abe, Takakuni; Kai, Shinya; Noguchi, Takayuki ;Full Source: Journal of Anesthesia & Clinical Research [online computer file]2011, 2(2), 1000122 (Eng) ;