Undiagnosed Lambert-Eaton Myasthenic Syndrome in the Era of Sugammadex: A Case Report.
Clin Neuropharmacol
; 46(6): 205-208, 2023.
Article
em En
| MEDLINE
| ID: mdl-37962306
ABSTRACT
OBJECTIVE:
In this case report, we discuss the rare manifestation of prolonged neuromuscular blockade in a patient with history of small cell lung cancer and undiagnosed Lambert-Eaton myasthenic syndrome (LEMS) who had previously received succinylcholine for general anesthesia without incident but subsequently exhibited prolonged neuromuscular blockade during a laparoscopic procedure. We aimed to emphasize the importance of reversal agent safety and precision as well as vigilant perioperative and postoperative care.METHODS:
We used the patient's electronic medical record, direct patient care experiences, and comprehensive literature review for this case report.RESULTS:
Sugammadex was administered with mild improvement. Suspecting undiagnosed LEMS, neostigmine was administered, yielding satisfactory muscle strength and successful extubation. In retrospect, the patient reported history of weakness when lifting weights that improved upon exertion.CONCLUSIONS:
Sugammadex is an efficient and effective agent for reversal of neuromuscular blockade. However, proper monitoring of the depth and recovery of blockade is imperative to when using sugammadex with optimal safety and precision in all patients. Perioperative care teams must remain vigilant with a high index of suspicion for neuromuscular junction pathology to properly plan perioperative care for patients at risk, especially those with small cell lung cancer who may have undiagnosed LEMS.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Síndrome Miastênica de Lambert-Eaton
/
Bloqueio Neuromuscular
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Carcinoma de Pequenas Células do Pulmão
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Neoplasias Pulmonares
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article