The peri-operative anaesthetic management of a patient with Myasthenia gravis poses significant challenge to the anaesthesiologist. A case of successful anaesthetic management of a Myasthenic patient with co-existing Ischemic Heart Disease, Bronchial Asthma and Type II diabetes mellitus, who underwent laparoscopic cholecystectomy with epigastric hernia repair is reported. The authors review the anaesthetic considerations in the management of a patient with Myasthenia gravis having coexisting systemic diseases.
Fambrough DM, Drachman DB, Satyamurti S. Neuromuscular junction in myasthenia gravis: Decreased acetylcholine receptors. Science 1973; 182:293-295.
Review Myasthenia gravis: past, present, and future. Conti-Fine BM, Milani M, Kaminski HJ J clin Invest.2006 Nov; 116(11):2843-54.
Leventhal SR, Orkin FK, Hirsh RA. Prediction of the need for postoperative mechanical ventilation in myasthenia gravis. Anesthesiology 1980; 52 :26-30.
Osserman KE, Genkins G. Studies in myasthenia gravis: Review of a twenty-year experience in over 1200 patients. Mt Sinai J Med 1971 ; 38:497-537.
Jaretzki A, Barohn RJ, Ernstoff RM,et al. (2000).”Myasthenia gravis: recommendations for clinical research standards. Task Force of the Myasthenia Gravis Foundation of America”.Neurology 55 (1): 16-23.
Dillon FX. Anesthesia issues in the periperative management of myasthenia gravis. Semin Neurol.2004;24:83-94.
Mincewicz G, Aloszko A, Nyka W, Bilinska M, Krzykowski G, Nyka WM. The comparison of selected spirometric parameters with functional muscles exercise evaluation in patients with myasthenia (Polish)Pol Merkur Lek.2007;22:177-81.
Haroun-Bizri S, Maalouuullli J, Deeb P, Baraka A. Anesthetic management for a patient with myasthenia gravis undergoing coronary artery bypass graft. Middle East J Anesthesiol.2003; 17:299-305.
Helipoulos I, PatlakasG, Vadikolias K, et al. Maimal voluntary ventilation in myasthenia gravis. Muscle Nerve.2003;27:715-9 .
Nilsson E, Meretoja OA. Vecuronium dose-response and maintenance requirements in patients with myasthenia gravis . Anesthesiology 1990;73:28-32.
Lin CC,Chen HM, et al. Prpofol anesthesia in a patient with myasthenia gravis-a case report. Acta Anaesthesiology. Sin 1996;34:89-92.
Eisenkraft JB, Papatestas AE, Sivak M. Neuromuscular effects of halogenated agents in patients with myasthenia gravis(abstract).Anesthesiology 1984;61: A307.
Takeda J, Izawa H, Ochiai R, et al. Suppression of neuromuscular transmission by sevoflurane in patients with myasthenia gravis (abstract).Anesthesiology 1993; 79:A960.
Nishi M, Nakagawa H< Komatsu R, et al. Neuromuscular effects of sevoflurane in a patient with myasthenia gravis. Anaesth 1993; 7:237-239.
Breucking E, Mortier W. Anesthesi in neuromuscular diseases. Acta Anaesthesiol Belg.1990;41(2): 127-32.
Fry DL, Hyatt RE. Pulmonary mechanics: A unified analysis of the relationship between pressure, volumeand gasflow in lungs of normal and diseased human subjects. Am J Med 1960;29: 672-689.
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