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Neurologische, neuromusculaire en psychiatrische pathologie

Neurologische, neuromusculaire en psychiatrische pathologie

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Myast<strong>en</strong>ia Gravis <strong>en</strong> Anesthesie (II)<br />

• Niet-depolariser<strong>en</strong>de NMB<br />

– Verhoogde gevoeligheid (10-100 x)<br />

– ED 95: Vecuronium: 40 - 55 % ↓<br />

– Atracurium: 58 % ↓<br />

– NM - monitor: Tc - T4/T1<br />

• Depolariser<strong>en</strong>de NMB<br />

– ED 95: Succinylcholine: 2.6 x ↑ (dosis: 1.5-2.0 mg/kg)<br />

– Verhoogde kans tot fase II blok<br />

• Inhalatieanesthetica<br />

– Toeg<strong>en</strong>om<strong>en</strong> musculaire relaxatie (sevo, iso, des)<br />

• Interacties thv NM junctie<br />

– AB: aminoglycosid<strong>en</strong>, polymyxines<br />

– β -blokkers, procainamide, ph<strong>en</strong>ytoine

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