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Neuromuscular effects of isoflurane in patients with myasthenia gravis
Author(s) -
Nilsson E.,
Muller K.
Publication year - 1990
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1990.tb03056.x
Subject(s) - medicine , myasthenia gravis , isoflurane , neuromuscular monitoring , anesthesia , neuromuscular transmission , neuromuscular junction , neuromuscular blockade , neuroscience , biology
Seventeen myasthenia gravis and seven control patients were studied mechano (MMG)‐ and electromyographically (EMG) during isoflurane/oxygen/air anaesthesia. In myasthenic patients the mean train‐of‐four ratio and neuromuscular block (by MMG) during 1.9 MAC isoflurane anaesthesia were 55 ± 9% and 46 ± 12%, respectively. The correlation between simultaneous MMG and EMG measurements was excellent (r 2 =0.933, P <0.001). The occurrence of HLA‐B8 together with acetylcholine receptor antibodies seems to predispose myasthenic patients to a neuromuscular depression produced by isoflurane. Our current and prior results show that isoflurane possesses approximately twice as strong a neuromuscular blocking effect as halothane in myasthenic patients.