SPECIFIC MANAGEMENT OF MYASTHENIA GRAVIS IN PATIENTS UNDERGOING ABDOMINAL CANCER SURGERIES
21 clinical cases of abdominal cancer surgery in patients with concomitant myasthenia gravis are combined with the use of the “pharmacological duet” of rocuronium ‒ sugammadex and the mandatory monitoring of neuromuscular conduction. In all cases, surgery procedures were performed under combined ane...
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Format: | Article |
Language: | Russian |
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New Terra Publishing House
2019-07-01
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Series: | Вестник анестезиологии и реаниматологии |
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Online Access: | https://www.vair-journal.com/jour/article/view/336 |
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author | V. E. GRUZDEV E. S. GOROBETS V. V. KULАBUKHOV А. А. MOROZOVА M. А. АNISIMOV |
author_facet | V. E. GRUZDEV E. S. GOROBETS V. V. KULАBUKHOV А. А. MOROZOVА M. А. АNISIMOV |
author_sort | V. E. GRUZDEV |
collection | DOAJ |
description | 21 clinical cases of abdominal cancer surgery in patients with concomitant myasthenia gravis are combined with the use of the “pharmacological duet” of rocuronium ‒ sugammadex and the mandatory monitoring of neuromuscular conduction. In all cases, surgery procedures were performed under combined anesthesia with sevoflurane and low-dose epidural ropivacaine + fentanyl + norepinephrine. In all cases, except one, when the mechanical ventilation was planned and determined by the severity of the operation, blood loss and hypothermia, it was possible to reliably restore the spontaneous breathing immediately after the end of the operation. The necessity of an individual approach to patients suffering from myasthenia gravis, due to the difference in its severity and degree of compensation, is clearly shown. It was especially emphasized that with subcompensated state, incomplete efficacy of sugammadex is possible and additional intravenous administration of anticholinesterase drugs may be required (2 cases). In addition, in severe myasthenia gravis, a discrepancy is possible between “safe” TOF = 90% and clinical signs of residual respiratory failure (1 case). |
first_indexed | 2024-03-12T03:32:19Z |
format | Article |
id | doaj.art-eb4647410d724e96a751caf2a29f8cd4 |
institution | Directory Open Access Journal |
issn | 2078-5658 2541-8653 |
language | Russian |
last_indexed | 2024-03-12T03:32:19Z |
publishDate | 2019-07-01 |
publisher | New Terra Publishing House |
record_format | Article |
series | Вестник анестезиологии и реаниматологии |
spelling | doaj.art-eb4647410d724e96a751caf2a29f8cd42023-09-03T13:24:41ZrusNew Terra Publishing HouseВестник анестезиологии и реаниматологии2078-56582541-86532019-07-01163485410.21292/2078-5658-2019-16-3-48-54315SPECIFIC MANAGEMENT OF MYASTHENIA GRAVIS IN PATIENTS UNDERGOING ABDOMINAL CANCER SURGERIESV. E. GRUZDEV0E. S. GOROBETS1V. V. KULАBUKHOV2А. А. MOROZOVА3M. А. АNISIMOV4ФГБУ «НМИЦ им. Н. Н. Блохина» МЗ РФФГБУ «НМИЦ им. Н. Н. Блохина» МЗ РФФГБУ «НМИЦ им. Н. Н. Блохина» МЗ РФФГБУ «НМИЦ им. Н. Н. Блохина» МЗ РФФГБУ «НМИЦ им. Н. Н. Блохина» МЗ РФ21 clinical cases of abdominal cancer surgery in patients with concomitant myasthenia gravis are combined with the use of the “pharmacological duet” of rocuronium ‒ sugammadex and the mandatory monitoring of neuromuscular conduction. In all cases, surgery procedures were performed under combined anesthesia with sevoflurane and low-dose epidural ropivacaine + fentanyl + norepinephrine. In all cases, except one, when the mechanical ventilation was planned and determined by the severity of the operation, blood loss and hypothermia, it was possible to reliably restore the spontaneous breathing immediately after the end of the operation. The necessity of an individual approach to patients suffering from myasthenia gravis, due to the difference in its severity and degree of compensation, is clearly shown. It was especially emphasized that with subcompensated state, incomplete efficacy of sugammadex is possible and additional intravenous administration of anticholinesterase drugs may be required (2 cases). In addition, in severe myasthenia gravis, a discrepancy is possible between “safe” TOF = 90% and clinical signs of residual respiratory failure (1 case).https://www.vair-journal.com/jour/article/view/336myasthenia gravisполостные операциирокуронийсугаммадексtof мониторингантихолинэстеразные препараты |
spellingShingle | V. E. GRUZDEV E. S. GOROBETS V. V. KULАBUKHOV А. А. MOROZOVА M. А. АNISIMOV SPECIFIC MANAGEMENT OF MYASTHENIA GRAVIS IN PATIENTS UNDERGOING ABDOMINAL CANCER SURGERIES Вестник анестезиологии и реаниматологии myasthenia gravis полостные операции рокуроний сугаммадекс tof мониторинг антихолинэстеразные препараты |
title | SPECIFIC MANAGEMENT OF MYASTHENIA GRAVIS IN PATIENTS UNDERGOING ABDOMINAL CANCER SURGERIES |
title_full | SPECIFIC MANAGEMENT OF MYASTHENIA GRAVIS IN PATIENTS UNDERGOING ABDOMINAL CANCER SURGERIES |
title_fullStr | SPECIFIC MANAGEMENT OF MYASTHENIA GRAVIS IN PATIENTS UNDERGOING ABDOMINAL CANCER SURGERIES |
title_full_unstemmed | SPECIFIC MANAGEMENT OF MYASTHENIA GRAVIS IN PATIENTS UNDERGOING ABDOMINAL CANCER SURGERIES |
title_short | SPECIFIC MANAGEMENT OF MYASTHENIA GRAVIS IN PATIENTS UNDERGOING ABDOMINAL CANCER SURGERIES |
title_sort | specific management of myasthenia gravis in patients undergoing abdominal cancer surgeries |
topic | myasthenia gravis полостные операции рокуроний сугаммадекс tof мониторинг антихолинэстеразные препараты |
url | https://www.vair-journal.com/jour/article/view/336 |
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