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Combination of balanced and regional anaesthesia for minimally invasive surgery in a patient with myasthenia gravis

Published online by Cambridge University Press:  16 August 2006

M. Hübler
Affiliation:
University Hospital Carl Gustav Carus, Department of Anaesthesiology and Critical Care, Dresden, Germany
R. J. Litz
Affiliation:
University Hospital Carl Gustav Carus, Department of Anaesthesiology and Critical Care, Dresden, Germany
D. M. Albrecht
Affiliation:
University Hospital Carl Gustav Carus, Department of Anaesthesiology and Critical Care, Dresden, Germany
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Abstract

A 45-year-old man with cryptorchism, who was known to suffer from generalized myasthenia gravis, was admitted to hospital for surgical treatment using laparoscopy. Such minimally invasive surgery requires good muscle relaxation. However, the use of neuromuscular blocking agents in patients with myasthenia gravis may lead to prolonged apnoea after operation, thus necessitating mechanical ventilation of the lungs. We used a combination of general anaesthesia (with desflurane), and epidural anaesthesia (with the amide local anaesthetic ropivacaine) to obtain excellent abdominal relaxation during surgery. Tracheal extubation was possible immediately after the operation and no adverse effects were observed. The patient was discharged from hospital on the second day after operation. The combination of regional and general anaesthesia for minimally invasive surgery in this patient permitted safe anaesthetic management.

Type
Clinical Letter
Copyright
2000 European Society of Anaesthesiology

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