Lal, Jatin Pandit Bhagwat Dayal Sharma University of Health Sciences - Department of Anaesthesiology Critical Care, India , Bansal, Teena Pandit Bhagwat Dayal Sharma University of Health Sciences - Department of Anaesthesiology Critical Care, India

Myasthenia gravis: Anaesthetic implications and considerations-a report of two cases

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Myasthenia gravis is an autoimmune disease characterized by weakness and fatigueability ofskeletal muscles with improvement following rest. Perioperative management of such a patientposes a significant challenge to the anaesthesiologist, because it affects the neuromuscular junction. Also, the association of myasthenia gravis with other autoimmune disorders is well known. Preoperative evaluation of the patient includes review of the severity of the patient’s disease and the treatment regimen. Optimisation of the condition of the myasthenic patient can markedly decrease the risk of surgery and improve the outcome. Anaesthetic management must be accomplished with the minimal applicable dose of the anaesthetic agents. Because of the unpredictable response to succinylcholine and the marked sensitivity to non depolarizing muscle relaxants, muscle relaxants should be avoided. All patients should be closely monitored postoperatively in the post anaesthesia care unit or surgical intensive care unit, where respiratory support can be immediately reinstituted.

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Myasthenia gravis , anaesthetic implications , anaesthetic management

Cumhuriyet Medical Journal

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