Anesthesia and neuromuscular block management in thymectomies performed in cases of thymoma and myasthenia gravis: A retrospective study


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Saylan S. , Akdoğan A.

Annals of Clinical and Analytical Medicine, vol.12, no.3, pp.327-331, 2021 (Journal Indexed in ESCI)

  • Publication Type: Article / Article
  • Volume: 12 Issue: 3
  • Publication Date: 2021
  • Doi Number: 10.4328/acam.20485
  • Title of Journal : Annals of Clinical and Analytical Medicine
  • Page Numbers: pp.327-331

Abstract

Abstract

Aim: The aim of our study was to evaluate anesthesia management and the antagonism of neuromuscular blockade with sugammadex in thymectomies

performed in patients with thymoma and myasthenia gravis (MG), especially in terms of the postoperative residual block, complications, and its effect on

postoperative respiratory pattern.

Material and Methods: In order to evaluate the effectiveness of the anesthesia methods and neuromuscular block management procedures we use in thymectomy

cases in our clinic, patient files, anesthesia record forms, early postoperative follow-up, and the discharge process were retrospectively reviewed.

Patients who underwent thymectomy, used steroid neuromuscular blocking agents (NMBA) and preferred sugammadex for neuromuscular block antagonism

were included in the study.

Results: There was no difference between the time of anesthesia and surgery in patients, the total doses of rocuronium and sugammadex used, the time

between the onset of spontaneous respiration and extubation, and the time when spontaneous respiration was started without any intervention. In the early

postoperative period, complications such as reintubation due to respiratory failure, a decrease in peripheral O2 saturation below 90%, postoperative residual

neuromuscular block were not observed.

Discussion: We recommend using propofol as an intravenous general anesthetic agent in thymectomy surgery applied to patients with MG, performing total

intravenous anesthesia using propofol and opioid analgesics in anesthesia maintenance, and providing a good peroperative analgesia control. In addition, we

think that sugammadex may be preferred for steroid NMBA antagonism in this patient group.