Challenges in the Anesthetic Management for a Robotic Thymectomy in a Patient With Myasthenia Gravis: A Case Report.
We describe the case of a patient with myasthenia gravis undergoing a robotic-assisted thymectomy complicated by postoperative myasthenic crisis, with a focus on the anesthetic considerations specific to this case. Because myasthenia gravis is an autoimmune disease affecting acetylcholine receptors, caution must be taken with the use of neuromuscular blockade and reversal. Utilizing a robotic-assisted surgical approach makes anesthetic management challenging given the dangers of patient movement while the robot is docked, lung isolation, extubation criteria, and postoperative disposition.
From the Departments of *Anesthesiology, †Surgery, and ‡Neurology, University of North Carolina, UNC Hospitals, Chapel Hill, North Carolina.
Susan M
SM
Martinelli
Bilal D
BD
Lateef
Jason M
JM
Long
David Y
DY
Huang
Ameeta
A
Karmarkar
Brian P
BP
Barrick
D000768:Anesthesia, General / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects*; D013934:Thymectomy / Q000009:adverse effects* / Q000379:methods; D013958:Thyroid Crisis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome