Challenges in the Anesthetic Management for a Robotic Thymectomy in a Patient With Myasthenia Gravis: A Case Report. Issue 9 (1st May 2017)

• Record Type: Journal Article
• Authors: Martinelli, Susan M.; Lateef, Bilal D.; Long, Jason M.; Huang, David Y.; Karmarkar, Ameeta; Barrick, Brian P.
• Is Part Of: A & A case reports. Volume 8:Issue 9(2017:May 01)
• Publication Date: 2017-05-01
• Subjects: Anesthesiology -- Periodicals; Anesthesia -- Periodicals; Anesthesiology; Analgesia; Anesthesiology; Periodicals; 617.9605
• DOI: 10.1213/XAA.0000000000000471
• Languages: English
• ISSNs: 2325-7237

Abstract

Abstract : We describe the case of a patient with myasthenia gravis undergoing a robotic-assisted thymectomy complicated by postoperative myasthenic crisis, with a focus on the anesthetic considerations specific to this case. Because myasthenia gravis is an autoimmune disease affecting acetylcholine receptors, caution must be taken with the use of neuromuscular blockade and reversal. Utilizing a robotic-assisted surgical approach makes anesthetic management challenging given the dangers of patient movement while the robot is docked, lung isolation, extubation criteria, and postoperative disposition.