Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, München, Germany.
Anaesthesia. 2010 Mar;65(3):302-5. doi: 10.1111/j.1365-2044.2009.06236.x. Epub 2010 Jan 23.
Myasthenia gravis, affecting neuromuscular transmission, leads to a large variability in sensitivity to depolarising and non-depolarising neuromuscular blocking drugs. We report the successful use of the modified mu-cyclodextrin sugammadex in a myasthenic patient to reverse a rocuronium-induced deep level of neuromuscular block. After spontaneous neuromuscular recovery of T2 (second twitch of the train-of-four series), we administered 2 mg.kg(-1) of sugammadex intravenously, reversing neuromuscular blockade to a train-of-four ratio (T4/T1) > 90% within 210 s. Sugammadex, in combination with objective neuromuscular monitoring, can be used to reverse rocuronium-induced neuromuscular blockade in patients with myasthenia gravis, thereby avoiding the need for reversal with acetylcholinesterase inhibitors.
重症肌无力影响神经肌肉传递，导致对去极化和非去极化神经肌肉阻滞剂的敏感性存在较大差异。我们报告了改良型 m-环糊精型司可巴比妥钠在 1 例重症肌无力患者中成功逆转罗库溴铵诱导的深度神经肌肉阻滞的应用。在 T2（四串成串刺激的第二个肌颤搐）自主神经肌肉恢复后，我们静脉注射 2mg/kg 的司可巴比妥钠，210 秒内将神经肌肉阻滞逆转至四串成串刺激的 T4/T1 比值>90%。司可巴比妥钠联合客观神经肌肉监测可用于逆转重症肌无力患者罗库溴铵诱导的神经肌肉阻滞，从而避免使用乙酰胆碱酯酶抑制剂进行逆转。
