title: Low-dose spinal anesthesia for urgent laparotomy in severe myasthenia gravis.
abstract: Myasthenia gravis (MG) is an autoimmune disease with an incidence of 2-10/100,000 cases per year, characterized by muscle weakness secondary to destruction of postsynaptic acetylcholine receptors. In these patients, important perioperative issues remain unresolved, namely, optimal administration of cholinesterase inhibitors, risks of regional anesthesia, and prediction of need of postoperative mechanical ventilation. We describe the use of a low-dose spinal anesthesia in a patient with MG who was submitted for emergence exploratory laparotomy. The utilization of low-dose spinal anesthesia allowed us to perform surgery with no adverse respiratory or cardiovascular events in this patient.
authors.affiliation: Department of Anesthesiology, Hospital de Madrid, Madrid, Spain.
authors.forename: Miguel Angel Palomero
authors.initials: MA
authors.lastname: Rodríguez
authors.forename: Teresa Pérez
authors.initials: TP
authors.lastname: Mencía
authors.forename: Felipe Villar
authors.initials: FV
authors.lastname: Alvarez
authors.forename: Yolanda Laporta
authors.initials: YL
authors.lastname: Báez
authors.forename: Gloria María Santos
authors.initials: GM
authors.lastname: Pérez
authors.forename: Andrés López
authors.initials: AL
authors.lastname: García
keywords: Bupivacaine; low dose spinal anesthesia; myasthenia gravis; postoperative mechanical ventilation; respiratory complications; spinal anesthesia