Can preoperative evaluation predict the need for postoperative ventilation?

Can preoperative evaluation predict the need for postoperative ventilation?

Many scoring systems have been proposed as predictors of postoperative ventilation. Factors involved include the severity and duration of disease, pyridostigmine dose requirements, and surgical approach. No single system has proven to be a reliable predictor in prospective analysis. Preoperative evaluation aims at quantifying the strength of respiratory muscles. Frequently used studies include pulmonary function tests and arterial blood gas analysis. These tests assist in evaluating the need for mechanical ventilation on an individual basis postoperatively.

Elective surgery should be scheduled to coincide with periods of remission. Coexisting diseases must be optimally treated.

As of this writing, there are no reliable predictors of post-operative ventilatory requirements for myasthenic patients.