The Successful Recovery from Neuromuscular Blockade by Sugammadex in a Patient with Myasthenia Gravis

寛解期にある重症筋無力症(MG)患者の腹腔鏡下胃切除術において,ロクロニウム,スガマデクスを用いて安全に手術を終えることができた.ロクロニウム0.58mg/kg投与後(初回投与),T2出現までの時間は32分であった.ロクロニウムの追加は持続投与量換算すると2.5γ~5γであった(麻酔維持薬はセボフルラン).筋弛緩作用の蓄積傾向や減弱傾向など経時的変化は認めなかった.術後T2出現を確認の上,スガマデクス120mg(2mg/kg)投与し150秒後にTOF ratio 0.9の回復を得られた.他の報告でもMG患者においてスガマデクス投与後の筋弛緩作用からの回復は正常人と比し遅れる傾向があり,本症例でも同様の結果となった.

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