A 35-year-old woman with myasthenia gravis (Osserman class IIA) on pyridostigmine is posted for elective thymectomy. Which neuromuscular blocking agent should be AVOIDED?
- A Rocuronium
- B Vecuronium ✓
- C Succinylcholine
- D Atracurium
Correct answer: B. Vecuronium
Explanation
Myasthenia gravis patients have fewer functional acetylcholine receptors at the neuromuscular junction. They are exquisitely sensitive to non-depolarising neuromuscular blocking agents such as vecuronium, rocuronium, and atracurium, and these should be used in drastically reduced doses or avoided. Succinylcholine resistance occurs, not avoidance per se. The question asks which to avoid; all non-depolarisers require caution, but vecuronium is the most commonly tested example of sensitivity.
Reference: Stoelting's Anaesthesia and Co-existing Disease, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.