title: Rocuronium and sugammadex in patients with myasthenia gravis undergoing thymectomy.
abstract: BACKGROUND
  The use of neuromuscular blocking agents is still controversial in myasthenic patients but rocuronium could be useful after the introduction of sugammadex as a selective antagonist. The aim of the study was to evaluate the use of rocuronium-sugammadex in myasthenic patients undergoing thoracoscopic thymectomy.
  
  
  METHODS
  After ethical approval, 10 myasthenic patients undergoing videothoracoscopic-assisted thymectomy were enrolled in the study. Neuromuscular block was achieved with 0.3 mg/kg rocuronium and additional doses were given according to train-of-four (TOF) monitoring or movement of the diaphragm. Sugammadex 2 mg/kg was given after surgery. Recovery time (time to obtain a TOF value > 0.9) was recorded for all subjects.
  
  
  RESULTS
  All patients were extubated in the operating room after administration of sugammadex. Mean rocuronium dose was 48 mg and the average operation time was 62 min. Recovery time after sugammadex administration was 111 s (min 35; max 240).
  
  
  CONCLUSIONS
  A rapid recovery of neuromuscular function was found in myasthenic patients receiving rocuronium when sugammadex was used for reversal. This combination could be a rational alternative for myasthenic patients for whom neuromuscular blockade is mandatory during surgery.
authors.affiliation: Department of Anaesthesiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey.
authors.forename: Z
authors.initials: Z
authors.lastname: Sungur Ulke
authors.forename: A
authors.initials: A
authors.lastname: Yavru
authors.forename: E
authors.initials: E
authors.lastname: Camci
authors.forename: B
authors.initials: B
authors.lastname: Ozkan
authors.forename: A
authors.initials: A
authors.lastname: Toker
authors.forename: M
authors.initials: M
authors.lastname: Senturk
mesh_terms: D000328:Adult; D000732:Androstanols / Q000008:administration & dosage / Q000037:antagonists & inhibitors*; D000762:Anesthesia Recovery Period; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D009157:Myasthenia Gravis / Q000188:drug therapy / Q000209:etiology*; D019148:Neuromuscular Blockade / Q000009:adverse effects / Q000379:methods*; D061886:Neuromuscular Monitoring; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000037:antagonists & inhibitors*; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D000077123:Rocuronium; D012720:Severity of Illness Index; D000077122:Sugammadex; D020775:Thoracic Surgery, Video-Assisted; D013934:Thymectomy; D013945:Thymoma / Q000150:complications / Q000601:surgery*; D013953:Thymus Neoplasms / Q000150:complications / Q000601:surgery*; D047408:gamma-Cyclodextrins / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000732:Androstanols; D002800:Cholinesterase Inhibitors; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D011729:Pyridostigmine Bromide; D000077123:Rocuronium