Abstract
Myasthenia gravis (MG) is a rare neuromuscular disorder characterized by skeletal muscle weakness. Patients with MG who have thymoma and thymic hyperplasia have indications for thymectomy. The perioperative care of patients with MG scheduled for thymus resection should be focused on optimizing their neuromuscular function, identifying factors related to postoperative mechanical ventilation, and avoiding of triggers associated with myasthenic or cholinergic crisis. Minimally invasive surgical techniques, use of regional analgesia, and avoidance or judicious administration of neuromuscular blocking drugs (NMBs) is recommended during the perioperative period. If NMBs are used, sugammadex appears to be the drug of choice to restore adequately the neuromuscular transmission. In patients with postoperative myasthenic crisis, plasma exchange or intravenous immune globulin and mechanical support is recommended.
Original language | English (US) |
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Pages (from-to) | 2537-2545 |
Number of pages | 9 |
Journal | Journal of Cardiothoracic and Vascular Anesthesia |
Volume | 33 |
Issue number | 9 |
DOIs | |
State | Published - Sep 2019 |
Keywords
- mediastinum
- myasthenia gravis
- neuromuscular diseases
- surgery
- thoracic surgery
- thymoma
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Anesthesiology and Pain Medicine