title: Sensitivity to both vecuronium and neostigmine in a sero-negative myasthenic patient.
abstract: We describe a sero-negative ocular myasthenic patient who showed exaggerated responses to both vecuronium and neostigmine. These hypersensitive responses were not anticipated because preoperative clinical and laboratory evaluations suggested a negligible impairment of somatic muscles by myasthenic processes. This case report re-emphasizes that, if neuromuscular blocking agents and their antagonists are administered to myasthenic patients, regardless of the degree of impairment, the dose should be titrated carefully with the aid of a neuromuscular transmission monitor.
authors.affiliation: Department of Anesthesiology, University of Kansas, College of Health Sciences and Hospital, Kansas City 66103.
authors.forename: J M
authors.initials: JM
authors.lastname: Kim
authors.forename: J
authors.initials: J
authors.lastname: Mangold
mesh_terms: D000328:Adult; D001049:Apnea / Q000139:chemically induced*; D005260:Female; D006801:Humans; D009157:Myasthenia Gravis / Q000503:physiopathology*; D009388:Neostigmine / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology; D014673:Vecuronium Bromide / Q000009:adverse effects*
chemical_list: D009388:Neostigmine; D014673:Vecuronium Bromide