Abstract
The Myasthenia gravis (MG) is an autoimmune disease that affects neuromuscular transmission and leads to a large variation of sensibility on depolarizing and nondepolarizing neuromuscular blocking drugs. Sugammadex is a new drug with the capability to successfully revert the nondepolarizing neuromuscular blocking. This case report will show a patient with MG that was scheduled for thymectomy, with the objective to use sugammadex to reverse a rocuronium induced deep level of neuromuscular block and observing the safe use of sugammadex without complications.
Highlights
IntroductionMyasthenia gravis is an autoimmune disease caused by the blockade of neuromuscular transmission by antibodies against nicotinic acetylcholine receptors (AChRs), which are located in the postsynaptic membrane of the neuromuscular junction
This case report will show a patient with Myasthenia gravis (MG) that was scheduled for thymectomy, with the objective to use sugammadex to reverse a rocuronium induced deep level of neuromuscular block and observing the safe use of sugammadex without complications
Myasthenia gravis is an autoimmune disease caused by the blockade of neuromuscular transmission by antibodies against nicotinic acetylcholine receptors (AChRs), which are located in the postsynaptic membrane of the neuromuscular junction
Summary
Myasthenia gravis is an autoimmune disease caused by the blockade of neuromuscular transmission by antibodies against nicotinic acetylcholine receptors (AChRs), which are located in the postsynaptic membrane of the neuromuscular junction. Osserman and Genkins divided group 2) into the following subclassifications: A (mild) and B (moderate). This classification allows one to grade the disease and assess the perioperative risk and possible complications. Sugammadex is a modificated g-cyclodextrin (refers to sugar and gammadex refers to the structural molecule gcyclodextrin) It is a selective relaxant binding agent. It binds/encapsulates and renders inactive the steroidal neuromuscular blocking agents (NMBA) rocuronium, and vecuronium This decreases the concentration of unbound NMBA at the neuromuscular junction thereby reversing NMB [3]. Sugammadex has been administered and showed safe for use in patients with myasthenia gravis and may effectively reduce the risk of postoperative respiratory complications, but further research is needed to clarify key parameters in the analysis and to allow a fuller economic assessment
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