The use of sugammadex in a patient with myotonic dystrophy

Matsuki, Yuka; Hirose, Munetaka; Tabata, Mari; Nobukawa, Yasunari; Shigemi, Kenji

doi:10.1097/eja.0b013e3283405b87

Cited by 21 publications

(8 citation statements)

References 6 publications

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“…It is devoid of the risks of neostigmine and with better efficacy at reversal, has been suggested as a superior alternative. [ 4 5 6 ] We had decided to use rocuronium and sugammadex combination, to avoid the possible need for neostigmine to reverse any other relaxant as well as because of lack of quantitative neuromuscular monitoring with which we could ensure complete reversal. In contrast to the previous reports, where sugammadex was either given to avoid the possibility of residual paralysis[ 4 ] or less than normal dose of rocuronium was given for intubation,[ 6 ] we observed that using sugammadex, we could easily reverse a complete paralysis following the usual intubating dose of rocuronium (approximately 0.6 mg/kg).…”

mentioning

confidence: 99%

The successful use of sugammadex and uneventful recovery from general anaesthesia in a patient with myotonic dystrophy

Gurunathan

Duncan

2015

Indian J Anaesth

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confidence: 99%

The successful use of sugammadex and uneventful recovery from general anaesthesia in a patient with myotonic dystrophy

Gurunathan

Duncan

2015

Indian J Anaesth

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“…Reduced doses (< 0.6 mg/kg) of rocuronium have been administered to aid intubation in majority of the cases in our review 3 [13,20,[43][44][45][46][47][48][49]. With these cases, the reversal times to TOF ratio of 0.9 with 2 mg/kg sugammadex ranged from 2 min [20,45,46] to 5 min [13,44,48]. However, two authors have 3 Reduced dose of rocuronium has been used in these patients while the standard recommended dose of sugammadex has been successfully used to reverse muscle relaxants in the majority of the published case reports.…”

Section: Discussionmentioning

confidence: 99%

Use of sugammadex in patients with neuromuscular disorders: a systematic review of case reports

2019

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Background: Sugammadex is a modified gamma-cyclodextrin that acts by selectively encapsulating free aminosteroidal neuromuscular relaxants. Several case reports have been published on the use of sugammadex in patients with neuromuscular disorders that include neuromuscular junction diseases, myopathies, neuropathies, and motor neurone disorders. The primary aim of this review is to systematically review the evidence on the use of sugammadex in patients with this heterogeneous group of diseases and provide recommendations for clinical practice. Methods: A systematic electronic search of Medline, Embase and CINAHL databases was done until June 2019, to identify case reports describing the use of sugammadex in adult surgical patients with neuromuscular disorders. Results: Of the 578 records identified through database searches, 43 articles were finally included for the systematic review. Of these, 17 reports were on patients with myopathy, 15 reports on myasthenia gravis, 9 reports on motor neuron diseases and 2 reports on neuropathies. Conclusions: Majority of the articles reviewed report successful use of sugammadex to reverse steroidal muscle relaxants, especially rocuronium, in patients with neuromuscular diseases. However, with sugammadex, unpredictability in response and uncertainty regarding optimum dose still remain issues. Quantitative neuromuscular monitoring to ensure complete reversal and adequate postoperative monitoring is strongly recommended in these patients, despite the use of sugammadex.

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“…While non-depolarizing agents are generally well-tolerated, the antagonizing agent, neostigmine, has been reported to incompletely reverse neuromuscular blockade ( 3 ) and even cause a myotonic response ( 6 ). However, with the recent approval of sugammadex, safe and successful reversal of rocuronium has been reported with this patient population ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management for Multiple Family Members with Myotonic Dystrophy for Interventional Cardiac Procedures—A Case Series

Gorelik

Flores

2018

Front. Med.

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Myotonic muscular dystrophy (MMD) is a rare autosomal dominant disorder that can complicate anesthetic management of patients. MMD is characterized by progressively worsening muscle loss and weakness, cardiac conduction abnormalities, cardiomyopathy, restrictive lung disease, obstructive sleep apnea, and delayed gastric emptying. Patients presenting with MMD for any surgical procedure present a management challenge to the anesthesiologist. Several reports of airway loss due to medication-mediated respiratory depression, sudden death due to dysrhythmias, aspiration of stomach contents, and prolonged intubation have been reported. We present a case series of three family members with MMD type 1 who presented for electrophysiologic assessment of the cardiac conduction system and possible pacemaker insertion. While there are reports of anesthetic management of patients with myotonic dystrophy for various procedures, our report is unique in that we were able to demonstrate variations of anesthetic management based on the procedure and variation in disease phenotype—differing severity between family members.

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The use of sugammadex in a patient with myotonic dystrophy

Cited by 21 publications

References 6 publications

The successful use of sugammadex and uneventful recovery from general anaesthesia in a patient with myotonic dystrophy

The successful use of sugammadex and uneventful recovery from general anaesthesia in a patient with myotonic dystrophy

Use of sugammadex in patients with neuromuscular disorders: a systematic review of case reports

Anesthetic Management for Multiple Family Members with Myotonic Dystrophy for Interventional Cardiac Procedures—A Case Series

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