Ju Han Mun, Cheol Jong Woo, Jeongwoo Lee, Dong-Chan Kim, Jun Ho Lee, Vol. 2, No. 2, pp. 9-13, Sep. 2020
10.22662/IJBSA.2020.2.2.009, Full Text:
Keywords: Myasthenia gravis, Sugammadex, Nicotinic acetylcholine receptor, Acetylcholinesterase inhibitors, Cholinesterase, Neuromuscular blocking

Abstract

Background/Objectives: Myasthenia gravis (MG) is an autoimmune disease caused by the development of antibodies against the nicotinic acetylcholine receptor. Methods/Statistical analysis: MG causes weakness and fatigue of the respiratory muscles, so that there is hypersensitivity against non-depolarizing muscle relaxants. In general acetylcholinesterase inhibitors are administered to reverse the muscle blockade, but the use of neuromuscular blocking agents in myasthenic patients is usually delayed due to the drugs that already inhibit cholinesterase, resulting in a delay in spontaneous respiration. Sugammadex eliminates the effects of steroid non-depolarizing muscle relaxants, such as rocuronium and vecuronium, by selectively encapsulating their molecules. Case: We present a case of reversal of neuromuscular blocking agent and return to spontaneous respiration with sugammadex in a myasthenic patient. Findings: We also evaluated the degree of spontaneous respiration by comparing pulmonary function tests before and after surgery in a MG patient. Improvements/Applications: Sugammadex is a good option of fast reversal of neuromuscular blocking agent and return to spontaneous respiration in a myasthenic patient.

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