Management of Anesthesia in A Patient with Myasthenia Gravis

Summary Purpose: This report describes the management of anesthesia in a patient with myasthenia gravis, undergoing thymectomy. Clinical features: The patient was a 22-yr-old female. Thoracic computed tomography revealed a thymoma and a right-side paratracheal lymph node 46x44mm in size. A thymectomy operation was required. Low minimum alveolar concentration sevoflurane anesthesia and infusion of remifentanil was combined with thoracal epidural anesthesia. Without the use of muscle relaxant, the patient was administered tracheal intubation with leftsided double-lumen endotracheal tube for one lung ventilation. The operation was uneventful. At the end of surgery, the patient was easily extubated and transferred to the intensive care unit. Conclusion: This combination was well tolerated for tracheal intubation and allowed a quick transition to spontaneous breathing and a rapid recovery from anesthesia, good postoperative analgesia and an uneventful recovery. important for the anesthesiologist to be aware of possible signs of the disease and to be properly updated on the optimal perioperative anesthesiological management of the myasthenic patient [5]. This report describes the management of anesthesia in a patient with MG undergoing thymectomy.