Perioperative management of myasthenia gravis

The successful management of patients with MG requires a multidisciplinary approach and an understanding of the pathophysiology of the disease. The principles are to avoid exacerbation of muscle weakness and preserve respiratory function. Although NMBDs should be avoided where possible, using rocuronium and sugammadex as reversal agent is effective. Obstetric anaesthesia requires additional caution and careful consideration.