2019
DOI: 10.1016/j.jopan.2018.03.009
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Perianesthetic Implications and Considerations for Myasthenia Gravis

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Cited by 8 publications
(5 citation statements)
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“…The amount of anticholinesterase administered pre-operatively is a function of the necessity and dosage required of muscle relaxants for the particular procedure, with dosages possibly being withheld or reduced [14]. Corticosteroids can either be weaned off in MG patients, or those with long-term use of steroid treatment can receive one intravenous dose prior to surgery, as acute cessation of usage can contribute to perioperative hemodynamic instability [15].…”
Section: Discussionmentioning
confidence: 99%
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“…The amount of anticholinesterase administered pre-operatively is a function of the necessity and dosage required of muscle relaxants for the particular procedure, with dosages possibly being withheld or reduced [14]. Corticosteroids can either be weaned off in MG patients, or those with long-term use of steroid treatment can receive one intravenous dose prior to surgery, as acute cessation of usage can contribute to perioperative hemodynamic instability [15].…”
Section: Discussionmentioning
confidence: 99%
“…The patient should also exhibit normal cardiovascular function and present without any cardiac arrhythmias such as bradycardia or atrial fibrillation, ST and T wave abnormalities, and conductive deficits [14]. Coupling these assessments with a survey of the patient's degree of severity of MG, muscle groups involved, and their longitudinal disease management, as well as taking into account their current medications, ensures a correct and safe operative management plan is in place tailored both to the patient and the procedure being performed [15]. Post-operatively, it is important the patient exhibits unassisted ventilation with a patent airway, should be monitored for any signs of respiratory distress, and display no symptoms indicative of myasthenic or cholinergic crisis [1315].…”
Section: Discussionmentioning
confidence: 99%
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“…The efficacy of non-depolarizing muscle relaxants in myasthenia gravis patients is also significantly enhanced, and one-fourth of the standard intubating dose of rocuronium can achieve a complete neuromuscular block [129,130]. In addition, the use of muscle relaxants can aggravate myasthenia gravis and cause respiratory distress [131]. The pathogenesis of sarcopenia is complicated, especially the presence of motor unit remodeling; neuromuscular junction degeneration, including a reduction in the number of acetylcholine re-ceptors; endplate fragmentation; and reduction in postsynaptic folds, which may significantly change the pharmacological properties of muscle relaxants.…”
Section: Neuromuscular Blocking Agentsmentioning
confidence: 99%