Use of Sugammadex in Myasthenia Gravis and Becker Muscular Dystrophy: Four Cases

Abstract

Myasthenia gravis is an antibody-mediated autoimmune disease targeting nicotinic acid acetylcholine receptors in neuromuscular junctions. In myasthenia gravis, the number of nicotinic acid acetylcholine receptors is significantly reduced. This condition leads to muscular weakness and deserves special attention in terms of respiratory muscles. Becker muscular dystrophy is an X-linked recessive inherited disorder characterized by slowly progressive muscle weakness of the legs and pelvis. Sugammadex is a hydrophilic cyclodextrin molecule that has a lipophilic nucleus. It is an innovative molecule which terminates the effects of steroidal neuromuscular blocking agents via encapsulation. This is a report of the use of sugammadex in patients with MG and Becker muscular dystrophy. Three patients with myasthenia gravis; 55, 45 and 2.5 year-old; were enrolled the surgery under general anesthesia for the disc hernia repair, abdominal hysterectomy, and correcting of cataract, respectively. Additionally, a five-year-old patient with Becker muscular dystrophy was scheduled for circumcision and orchiopexy under general anesthesia. In all patients, rocuronium as a muscle relaxant and sugammadex for the reverse of rocuronium were administered. Tracheal extubation was achieved in all patients at the end of operations without complications. The use of a combination of rocuronium-sugammadex seems safe in muscle diseases without the development of any possible complications.