naa a22 4500 51074348X CHVBK 20180411083036.0 cr unu---uuuuu 180411e20131201xx s 000 0 eng 10.1007/s12630-013-0042-4 doi (NATIONALLICENCE)springer-10.1007/s12630-013-0042-4 Monitoring of neuromuscular blockade in one muscle group alone may not reflect recovery of total muscle function in patients with ocular myasthenia gravis [Elektronische Daten] [Hajime Iwasaki, Kenichi Takahoko, Shigeaki Otomo, Tomoki Sasakawa, Takayuki Kunisawa, Hiroshi Iwasaki] Le monitorage du bloc neuromusculaire dans un groupe de muscles peut ne pas refléter la récupération de la totalité de la fonction musculaire chez des patients souffrant de myasthénie oculaire Purpose: We report on two patients with ocular myasthenia gravis who received rocuronium, followed later by sugammadex to reverse neuromuscular blockade. Recovery was monitored simultaneously at the adductor pollicis muscle (APM) and the corrugator supercilii muscle (CSM). Clinical features: Two patients with ocular myasthenia gravis (case 1: 74yr-old female, 54kg; case 2: 71yr-old male, 72kg) were scheduled for surgery under general anesthesia. Neuromuscular blockade was induced with rocuronium 0.3mg·kg−1 after placing two separate monitors at the APM and the CSM, respectively. Additional doses of rocuronium 0.1-0.2mg·kg−1 were given to maintain neuromuscular blockade at fewer than two twitches at the APM during surgery. Train-of-four response at the CSM did not show recovery of the twitch after its initial disappearance. At the end of surgery, sugammadex was administered. Twitch height at the APM recovered to the control value in 12min (case 1) and 13min (case 2) after sugammadex administration; however, twitch height at the CSM took 26min (case 1) and 14min (case 2) to recover to the control value. Conclusion: After rocuronium-induced paralysis in both patients with ocular myasthenia, spontaneous recovery and sugammadex-assisted recovery were slower at the CSM than at the APM. In patients without the disorder, CSM recovery is faster than APM recovery. Thus, in ocular myasthenia gravis, neuromuscular recovery at the APM may not reflect recovery of all muscles. Canadian Anesthesiologists' Society, 2013 Iwasaki Hajime Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut Takahoko Kenichi Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut Otomo Shigeaki Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut Sasakawa Tomoki Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut Kunisawa Takayuki Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut Iwasaki Hiroshi Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/12(2013-12-01), 1222-1227 0832-610X 60:12<1222 2013 60 12630 https://doi.org/10.1007/s12630-013-0042-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-013-0042-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Iwasaki Hajime Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Takahoko Kenichi Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Otomo Shigeaki Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Sasakawa Tomoki Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Kunisawa Takayuki Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Iwasaki Hiroshi Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, 078-8510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/12(2013-12-01), 1222-1227 0832-610X 60:12<1222 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer