title: [Bilateral paravertebral block anesthesia for thymectomy by video-assisted thoracoscopy in patients with myasthenia gravis].
abstract: Thymectomy continues to be the treatment of choice for certain patients with myasthenia gravis. As surgical techniques have developed, anesthesiologists have considered the need to adapt anesthetic techniques to improve care of patients undergoing this procedure. We describe the anesthetic management of 2 patients undergoing thymectomy performed with a bilateral thoracoscopic approach. Because it is best to avoid the use of opiates during and after surgery, we performed a bilateral paravertebral thoracic block, inserting the catheters into the paravertebral space on each side to infuse local anesthetics on either side as needed as the operation progressed. Surgery was completed without adverse events and tubes were removed from the tracheas of both patients at the end of the procedures. Bilateral continuous infusion of local anesthetics provided satisfactory analgesia on the following days.
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid.
authors.forename: J L
authors.initials: JL
authors.lastname: López-Berlanga
authors.forename: I
authors.initials: I
authors.lastname: Garutti
authors.forename: E
authors.initials: E
authors.lastname: Martínez-Campos
authors.forename: P
authors.initials: P
authors.lastname: Piñeiro
authors.forename: D
authors.initials: D
authors.lastname: Salvatierra
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods; D000732:Androstanols / Q000008:administration & dosage / Q000493:pharmacokinetics; D000769:Anesthesia, Inhalation; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D000075202:Contraindications; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008738:Methyl Ethers; D009157:Myasthenia Gravis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D009407:Nerve Block; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000493:pharmacokinetics; D010149:Postoperative Pain / Q000517:prevention & control; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D000077123:Rocuronium; D000077149:Sevoflurane; D020775:Thoracic Surgery, Video-Assisted; D013934:Thymectomy; D013945:Thymoma / Q000150:complications / Q000601:surgery*; D013953:Thymus Neoplasms / Q000150:complications / Q000601:surgery*
chemical_list: D000732:Androstanols; D000779:Anesthetics, Local; D008738:Methyl Ethers; D003473:Neuromuscular Nondepolarizing Agents; D000077149:Sevoflurane; D011729:Pyridostigmine Bromide; D000077123:Rocuronium