In this episode, I’ll discuss the use of sugammadex in myasthenia gravis patients undergoing thymectomy.
A group of authors in Japan recently analyzed the association between the use of sugammadex and postoperative myasthenic crisis in patients with myasthenia gravis using a national inpatient database.
506 patients who received sugammadex were compared with 289 controls who did not receive sugammadex.
The sugammadex group was associated with a decrease in postoperative myasthenic crisis with an odds ratio of 0.48.
The sugammadex group also had a shorter median length of hospital stay by 1 day than the control group and a corresponding $1000 lower total cost of care.
The authors concluded that their study indicates that sugammadex should be used for MG patients who receive thymectomy for reversal of muscle paralysis after surgery rather than anticholinesterase.
Oddly, the study does not provide any details on the use of neuromuscular blocking agents between groups, including the agent or dose used. The study is based on coded data of patients who received sugammadex for NMBA reversal, but additional data on the NMBAs and doses used would be nice to have.
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