A new approach to anesthesia management in myasthenia gravis: reversal of neuromuscular blockade by sugammadex.
SourceRevista Espanõla de Anestesiología y Reanimación, 57, 3, (2010), pp. 181-184
1 maart 2010
Article / Letter to editor
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Revista Espanõla de Anestesiología y Reanimación
SubjectDCN 1: Perception and Action; N4i 4: Auto-immunity, transplantation and immunotherapy
A neuromuscular blocking drug (NMBD) induced neuromuscular blockade (NMB) in patients with myasthenia gravis usually dissipates either spontaneously or by administration of neostigmine. We administered sugammadex to a patient with myasthenia gravis to reverse a rocuronium-induced profound NMB. NMBDs predispose such patients to severe postoperative residual paralysis and respiratory complications. Sugammadex binds steroidal NMBDs and, therefore reverses a rocuronium or vecuronium-induced NMB, without interfering with cholinergic transmission. A rapid and complete recovery from profound NMB was achieved and no adverse events were observed. This case suggests that sugammadex is a safe and effective antagonist of a rocuronium induced NMB blockade in patients with myasthenia gravis.
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