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

Abstract

DOI: 10.4328/ACAM.20485 Received: 2021-01-15 Accepted: 2021-01-31 Published Online: 2021-02-06 Printed: 2021-03-01 Ann Clin Anal Med 2021;12(3):327-331 Corresponding Author: Sedat SAYLAN, Karadeniz Technical University Faculty of Medicine, Department of Anesthesiology and Intensive Care Medicine, Trabzon, Turkey. E-mail: [email protected] P: +90 (462) 377 57 41 F: +90 (462) 325 53 98 Corresponding Author ORCID ID: https://orcid.org/0000-0002-4833-9455 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.