avoid NMBAs in patients with MG unless absolutely necessary. If NMBAs are necessary, the use of rocuroniumorvecuronium, and then reversal withsugammadex. Myasthenic patients, including those with only ocular MG and those in remission, have a variable, unpredictable response to administration of NMBAs compared with normal patients, as well as a variable response to NMBA reversal, including the possibility of cholinergic crisis. They tend to be resistant to depolarizing NMBAs and very sensitive to nondepolarizing NMBAs. In addition, treatment with anticholinesterase medication affects the degree of relaxation and duration of action of NMBAs. If NMBAs are administered, the degree of neuromuscular blockade should be monitored using a quantitative train-of-four nerve stimulator.