Open AccessMyasthenia gravis and sugammadex: A case report and review of the literature
Author(s) -
Sujana Dontukurthy,
Carrie Wisler,
Vidya Raman,
Joseph D. Tobias
Publication year - 2020
Publication title -
saudi journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.416
H-Index - 24
eISSN - 1658-354X
pISSN - 0975-3125
DOI - 10.4103/sja.sja_721_19
Subject(s) - sugammadex , medicine , rocuronium , neostigmine , myasthenia gravis , thymectomy , neuromuscular blockade , neuromuscular blocking agents , anesthesia , neuromuscular monitoring , weakness , perioperative , vecuronium bromide , discontinuation , muscle weakness , surgery , propofol
Anesthesia care during surgical procedures in patients with myasthenia gravis (MG) can be challenging, as these patients have increased sensitivity to neuromuscular blocking agents (NMBAs) and may be at high risk for postoperative weakness and respiratory failure. Even intermediate-acting NMBAs may have a prolonged effect resulting in residual weakness after reversal with acetylcholinesterase inhibitors (neostigmine). Sugammadex (Bridion®, Merck and Co, Whithouse Stations, New Jersey) is a novel pharmacologic agent that reverses neuromuscular blockade by encapsulating rocuronium or vecuronium. We report the perioperative management of a 13-year-old adolescent girl with MG undergoing thymectomy. The use of sugammadex for reversal of neuromuscular blockade is discussed and the previous reports regarding its use in patients with MG are reviewed.