Sugammadex is safe and effective for patients with myasthenia gravis

Abstract

Thymoma, which can be surgically treated under general anesthesia, is associated with the pathophysiology of myasthenia gravis. Muscle weakness is a hallmark of myasthenia gravis; therefore, these patients are hypersensitive to the effects of nondepolarizing muscle relaxants. Neuromuscular blockers can cause prolonged postoperative muscle relaxation, leading to decreased respiratory function. Therefore, careful administration of muscle relaxants during the perioperative period is important. The neuromuscular antagonist, sugammadex, has been used to counteract problems associated with muscle relaxants. By encapsulating nondepolarizing muscle relaxants, sugammadex can reverse the neuromuscular blockade. Here we report three cases of myasthenia gravis. In each case, perioperative management included use of a train-of-four (TOF) monitor to minimize 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. © 2011 Shingu C, et al.