Does anesthesia affect myasthenia gravis?
The mechanisms are uncertain and may involve both pre- and postsynaptic effects. However, there have been no case reports of local anesthetic-induced weakness or myasthenic crisis in patients with MG.
Can you have surgery if you have myasthenia gravis?
For patients with myasthenia gravis (MG), elective surgery should be performed during a stable phase of the disease and should be scheduled early in the day. (See ‘Preoperative evaluation’ above.) Preoperative evaluation should include assessment of bulbar and respiratory symptoms.
Is Propofol contraindicated in myasthenia gravis?
Inductive agents such as propofol and fentanyl are safe substitutes that circumvent the possibility of myasthenic exacerbation, and are preferred for their short duration, minimal neuromuscular effects, and can be easily reversed in the event a crisis is precipitated.
Should not be administered to a patient with myasthenia gravis?
Antibiotics and Anti-Malarials The antibiotics most likely to worsen myasthenia are usually given in hospital, by injection, for very serious infections. The one exceptional drug that must be avoided in myasthenias is the ketolide antibiotic, Telithromycin (Ketek) which has caused deaths.
When should I intubate myasthenia gravis?
Over 20% of patients require intubation during evaluation in the emergency department, and almost 60% are intubated after admission to an intensive care unit. Elective intubation of a myasthenic patient with impending respiratory failure is favored over emergent intubation.
Can you use succinylcholine with myasthenia gravis?
To summarize, though not directly studied, the anesthesiology literature subjectively supports the use of succinylcholine as needed for intubation in patients with myasthenia gravis, perhaps with slight increase in RSI dose (2.0mg/kg). There is not theoretical risk or report of hyperkalemic response.
How do you reverse myasthenia gravis?
By preventing or reversing the muscle weakness, the other symptoms are prevented or reversed as well. Myasthenia gravis can’t be cured, but it is sometimes be treated with surgery to remove the thymus (which plays a role in the immune system) or with various drugs.
Is succinylcholine contraindicated in myasthenia gravis?
This is not the case in myasthenia gravis (there are fewer acetylcholine receptors), and there is no contraindication to its use. In myasthenia gravis, the destruction of acetylcholine receptors creates succinylcholine resistance and increased sensitivity to nondepolarizing agents.
Can you take muscle relaxants with myasthenia gravis?
Are there medications I should not take if I have MG? You should avoid drugs known to make MG symptoms worse, including certain antibiotics, beta blockers, calcium channel blockers, muscle relaxants and magnesium.