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July 29, 2026Reports — Medical Cases Images and VideosOpen Access

Anesthetic Management of a Patient with Advanced Anti-Myelin-Associated Glycoprotein Antibody Neuropathy in the Absence of Measurable Quantitative Neuromuscular Responses: A Case Report

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Authors

JYJun YamaguchiJTJoho TokumineKMKiyoshi Moriyama

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Overview

Case report demonstrates anesthetic strategies in advanced anti-MAG neuropathy, suggesting NMBA avoidance is viable.

Key Points

  • Evaluate anesthetic management options for patients with advanced anti-MAG antibody polyneuropathy and absent neuromuscular responses.
  • Case presentation of a 79-year-old man with anti-MAG neuropathy and persistent muscular weakness, scheduled for surgery.
  • Utilized electromyography and acceleromyography for neuromuscular monitoring before surgery, with significant limitations observed.
  • Executed robot-assisted radical cystectomy under general and thoracic epidural anesthesia without neuromuscular blocking agents.
  • No measurable neuromuscular response was found despite visible contractions, indicating significant monitoring challenges.
  • Surgery progressed without complications, allowing for effective anesthesia management without NMBA use.
  • Postoperative airway obstruction occurred but was resolved successfully with conservative interventions.

Cite This Study

Yamaguchi et al. (2026) studied this question.

synapsesocial.com/papers/6a69a28ac8da07d9defa60dfhttps://doi.org/10.3390/reports9030242
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