Challenges in the Anesthetic Management for a Robotic Thymectomy in a Patient With Myasthenia Gravis: A Case Report

A A Case Rep. 2017 May 1;8(9):222-225. doi: 10.1213/XAA.0000000000000471.

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.

Publication types

  • Case Reports

MeSH terms

  • Anesthesia, General / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Myasthenia Gravis / complications
  • Myasthenia Gravis / diagnosis
  • Myasthenia Gravis / surgery*
  • Risk Factors
  • Robotic Surgical Procedures / adverse effects*
  • Thymectomy / adverse effects*
  • Thymectomy / methods
  • Thyroid Crisis / diagnosis
  • Thyroid Crisis / etiology*
  • Thyroid Crisis / therapy
  • Treatment Outcome