The Neuromuscular Responses of Atracurium in Myasthenia Patieats / 대한마취과학회지

ABSTRACT

Myasthenia gravis is now considered as one of autoimmune disease eintities and characterized by progressive muscle weakness upon exertion and high sensitivity to the motor end plate. Special considerations are required in the anesthetic management of the myasthenic patient undergoing surgery under general anesthesia. The myasthenic patient is generally highly sensitve to non-depolarising agents and resistant to depolarizing agents. it is advisable to avoid the non-depolarzing agents or use only small dose during anesthesia, if neccessary. Atractrium is an intermediate acting bisquatenary ammonium compound and it's effects are well dissipated by hofmann elimination and ester hydrolysis. We have had myasthenic patient undergo thymectomy. Muscle relaxation was obtained by using a small dose of atracurium during anesthesia. Patient's perianesthetic course was not remarkable except slow spontaneous recovery, but it was well reversed by anticholinesterase.