The perioperative management of myasthenia gravis patients.

Myasthenia gravis (MG) is a disease affecting the acetylcholine receptor in the neuromuscular junction. Symptoms of MG are muscle weakness and fatigue. Anaesthesia and operation to MG patients need collaboration among the MG patients' health-care professionals. It is recommended that pyridostigmine is continued on the day of surgery. Most anaesthetic drugs are well tolerated by MG patients, but benzodiazepines and opiates may only be used with caution. For neuromuscular blockade rocuronium seems to be the best choice as it can be antagonized with sugammadex at the end of the surgical procedure.