Myasthenia Gravis and Thymoma Surgery: A Clinical Update for the Cardiothoracic Anesthesiologist

Research output: Contribution to journalReview article

2 Scopus citations

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 languageEnglish (US)
Pages (from-to)2537-2545
Number of pages9
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume33
Issue number9
DOIs
StatePublished - Sep 1 2019

Keywords

  • mediastinum
  • myasthenia gravis
  • neuromuscular diseases
  • surgery
  • thoracic surgery
  • thymoma

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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