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  • Antagonism of the Effect of...
    Sarıçiçek, Vahap; Gaziantep University, Department of Anesthesiology and Reanimation, Gaziantep, Turkey; Şahin, Mehrican; Gaziantep Cengiz Gökçek Gynecology and Obstetrics Hospital, Anesthesiology and Reanimation Clinic, Gaziantep, Turkey; Kadı, Çiğdem; Gaziantep University, Department of Anesthesiology and Reanimation, Gaziantep, Turkey; Mızrak, Ayşe; Gaziantep University, Department of Anesthesiology and Reanimation, Gaziantep, Turkey; Cesur, Mehmet; Gaziantep University, Department of Anesthesiology and Reanimation, Gaziantep, Turkey

    Inönü Üniversitesi Turgut Özal Tıp Merkezi dergisi, 06/2015
    Journal Article

    Myasthenia Gravis (MG) is an autoimmune disorder which is characterized by the decrease of number, function, and capacity of ach receptors in muscle-nerve junctions. Anaesthesia is important patients with MG especially when they need muscle relaxants, which is a risky condition due to the possibility of postoperative residual neuromuscular blockage. Before the discovery of Sugammadex, colinesterase inhibitors were used to reverse the effects of non-depolarising muscle relaxants to treat MG patients. In these cases, practitioners had to deal with several side effects in MG patients. Sugammadex encapsules the steroid structured muscle relaxants and immediately reverses their effects. Therefore, anaesthesiologists started to use Sugammadex to decrease the need of postoperative residual blockage and mechanical ventilation. In this case report, we aim to share our experiences of Sugammadex use and relate readers how it eliminated the effect of rocuronium in an MG patient who underwent VATS AbstractMyasthenia Gravis (MG) is an autoimmune disorder which is characterized by the decrease of number, function, and capacity of ach receptors in muscle-nerve junctions. Anaesthesia is important patients with MG especially when they need muscle relaxants, which is a risky condition due to the possibility of postoperative residual neuromuscular blockage. Before the discovery of Sugammadex, colinesterase inhibitors were used to reverse the effects of non-depolarising muscle relaxants to treat MG patients. In these cases, practitioners had to deal with several side effects in MG patients. Sugammadex encapsules the steroid structured muscle relaxants and immediately reverses their effects. Therefore, anaesthesiologists started to use Sugammadex to decrease the need of postoperative residual blockage and mechanical ventilation. In this case report, we aim to share our experiences of Sugammadex use and relate readers how it eliminated the effect of rocuronium in an MG patient who underwent VATS.Key Words: Myasthenia Gravis; Rocuronium; Sugammadex. Özet Myastenia Gravis (MG), kas sinir kavşağında asetilkolin reseptörlerin sayı ve fonksiyon kapasitesinin azalması ile karakterize otoimmun bir hastalıktır. Myastenia gravisli hastaların kas gevşetici kullanılması gereken durumlarda artmış postoperatif residüel nöromusküler blokaj riski nedeniyle anestezisi önem arz etmektedir. Sugammadeksin keşfinden önce non depolarizan kas gevşeticilerin etkisini geri döndürmede kullanılan kolinesteraz inhibitörleri spesifik bir antagonist olmadığı gibi aynı zamanda MG hastaların tedavisinde de kullanılmaktadır. Bu durum MG’li hastalarda istenmeyen etkilere yol açabilmektedir. Sugammadeks steroid yapılı kas gevşeticileri enkapsule ederek etkilerini hızlı bir şekilde ortadan kaldırır. Bu özelliğinden dolayı MG’li hastalarda postoperatif rezidüel blok ve mekanik ventilasyon gereksinimini azaltmak amacıyla anestezistler tarafından kullanılmaya başlanmıştır. Bu olgu sunumunda, VATS yapılan bir hastada rokuronyumun etkisinin sugammadeksle antagonize edilmesi ile ilgili deneyimimizi paylaşmayı amaçladık.Anahtar Kelimeler: Myastenia Gravis; Rokuronyum; Sugammadeks.