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