[Anesthetic considerations for thymectomy in a patient having an anti-acetylcholine receptor antibody without myasthenia gravis]

Abstract

A patient having an anti-acetylcholine receptor (AChR) antibody without myasthenia gravis was scheduled for thymectomy. Neuromuscular blockade monitoring showed a normal response to vecuronium in the patient. This finding suggests that sensitivities to neuromuscular blocking agents in the patients depend not on the titers of the antibody but also on the presence or absence of the preoperative symptoms such as muscle weakness. It is, however, recommended that neuromuscular blocking agents should be administered carefully under monitoring the neuromuscular function, as is the case for myasthenia gravis, because little is understood about the effect of neuromuscular blocking agent on the neuromuscular function in the asymptomatic patients having anti-AChR antibody.