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High-dose rocuronium for rapid-sequence induction and reversal with sugammadex in two myasthenic patients
- Source :
- Acta Anaesthesiologica Scandinavica. 58:1154-1158
- Publication Year :
- 2014
- Publisher :
- Wiley, 2014.
-
Abstract
- The anesthetic management of patients affected by myasthenia gravis is usually challenging in elective surgery and even more so in emergency procedures. The difficulties involved are several-fold, ranging from the choice of an appropriate muscle relaxant (i.e. one that enables safe and rapid airway management) to neuromuscular monitoring and normal muscular recovery. Additionally, optimizing patient conditions - either pharmacologically or with plasmapheresis - before intervention is well beyond the realm of possibility. We discuss the anesthetic management of two myasthenic patients undergoing emergency surgery (for sigmoid perforation and upper gastrointestinal bleeding respectively). In both cases, we opted for rapid-sequence induction with high-dose rocuronium to prevent inhalation of gastric contents. We also report on the implication of neuromuscular monitoring. We found that the rocuronium-sugammadex combination was a useful and effective option in the emergency setting.
- Subjects :
- medicine.medical_specialty
medicine.drug_class
business.industry
medicine.medical_treatment
Perforation (oil well)
Muscle relaxant
General Medicine
Rapid sequence induction
medicine.disease
Neuromuscular monitoring
Sugammadex
Surgery
Anesthesiology and Pain Medicine
Anesthesia
medicine
Upper gastrointestinal bleeding
Rocuronium
Elective surgery
business
medicine.drug
Subjects
Details
- ISSN :
- 00015172
- Volume :
- 58
- Database :
- OpenAIRE
- Journal :
- Acta Anaesthesiologica Scandinavica
- Accession number :
- edsair.doi...........6af6c52b89d4a3defc6b8b62bc6e746d