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Journals / Türk Anestezi ve Reanimasyon Dergisi / 2004 / Cilt: 32 - Sayı: 5

Total intravenous anaesthesia with remifentanil and propofol for laparoscopy in Myasthenia gravis

Miyastenia gravisli olguda laparoskopik cerrahide remifentanil ve propofol ile total intravenöz anestezi

Nurten KAYACAN
Bilge KARSLI
Münire AKAR
Fatma ERTUĞRUL
Suat ŞANLI
Mert AKBAŞ
Pages
395–399
Publication Date
2022-11-05
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In this report we aimed to discuss the anesthetic management of a patient with myasthenia gravis undergoing diagnostic laparoscopy under total intravenous anaesthesia.

📌 3 Key Takeaways

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Objective & Hypothesis:Myasthenia gravis is an autoimmune disorder characterized by inactivation or reduction of the postsynaptic acetylcholine receptors in the neuromuscular junction by IgG antibodies.
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Key Findings & Data:One major problem for the anaesthesiologist involves the use of muscle relaxants in these patients.
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Conclusion & Impact:In this report we aimed to discuss the anesthetic management of a patient with myasthenia gravis undergoing diagnostic laparoscopy under total intravenous anaesthesia.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Myasthenia gravis is an autoimmune disorder characterized by inactivation or reduction of the postsynaptic acetylcholine receptors in the neuromuscular junction by IgG antibodies. One major problem for the anaesthesiologist involves the use of muscle relaxants in these patients. The myasthenic patient is typically sensitive to nondepolarizing neuromuscular blockers and shows resistance to depolarizing agents. The use of nondepolarizing agents in patients with myasthenia gravis, even in small doses for priming or defasciculation, results in respiratory depression that requires assisted ventilation and monitorization postoperatively.Several general anaesthetic techniques have been reported, although non has been proven to be superior to the others. There are few reports regarding the use of propofol and remifentanil in myasthenics as total intravenous anaesthesia without using muscle relaxants. In this report we aimed to discuss the anesthetic management of a patient with myasthenia gravis undergoing diagnostic laparoscopy under total intravenous anaesthesia.

Özet

Miyastenia gravis (MG), nöromüsküler kavşaktaki postsinaptik asetilkolin reseptörlerinin IgG antikorları ile inaktivasyonu veya azaltılması ile seyreden otoimmün bir hastalıktır. Bu hastalarda anestezistler açısından en büyük problem kas gevşetici kullanımıyla ilgilidir. Çünkü MG'li hastalarda tipik olarak nondepolarizan kas gevşeticilere aşırı duyarlılık, depolarizan ajanlara karşı da direnç söz konusudur. Nondepolarizan kas gevşeticilerin priming veya defasikülasyon için küçük dozlarda kullanılması bile, asiste ventilasyon ihtiyacı gerektirecek postoperatif solunum depresyonuna neden olabilmektedir.MG'li hastaların anestezik yönetimlerinde çeşitli genel anestezi teknikleri bildirilmekle birlikte, hiçbirinin diğerine üstünlüğü kanıtlanamamıştır. Bu hastalarda, remifentanil ve propofolün kas gevşetici kullanmadan, total intravenöz anestezide birlikte uygulanması ile ilgili az sayıda çalışma rapor edilmiştir.Bu olgu sunumunda, miyastenia gravis tanısı alan ve primer infertilite nedeniyle diagnostik laparoskopi planlanan bir hastada, remifentanil-propofol ile kas gevşetici kullanmadan, uyguladığımız total intravenöz anestezi tekniğini tartışmayı amaçladık.

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Cite This Article

KAYACAN, N., KARSLI, B., AKAR, M., ERTUĞRUL, F., ŞANLI, S., AKBAŞ, M. (2022). Total intravenous anaesthesia with remifentanil and propofol for laparoscopy in Myasthenia gravis. Türk Anestezi ve Reanimasyon Dergisi, Cilt: 32 - Sayı: 5, 395–399. https://ajindex.com/articles/620166

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