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Should Every “Myasthenic Thymectomy” Be Sent to ICU?

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Postoperative Care in Thoracic Surgery

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Abstract

Myasthenia gravis (MG), an autoimmune disease of neuromuscular junction, is associated with an interaction with the muscle relaxants (MR). Thymectomy is often the method of choice for its treatment; anesthetic and also postoperative management require meticulous preoperative evaluation, careful monitoring, and adequate dose titration. The frequency of video-assisted thoracoscopic extended thymectomy (VATET) is also increasing, thus making the use of MR obligatory. Introduction of sugammadex into modern practice has provided a safe choice to the avoidance of prolonged action of MR also in patients with MG. Still, postoperative management of MG can be challenging, including the risks of prolonged mechanical ventilation, both cholinergic and myasthenic crisis, and drug interactions. This chapter aims to give information about some approaches to obtain a safe postoperative period in patients with MG. The general approach to MG and also other operations of myasthenic patients are not included within the range of this chapter.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey

    Zerrin Sungur & Mert Şentürk

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  1. Zerrin Sungur
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  2. Mert Şentürk
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Correspondence to Zerrin Sungur .

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Editors and Affiliations

  1. Department of Anaesthesiology and Intensive Care, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey

    Mert Şentürk

  2. Department of Anaesthesiology and Intensive Care, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey

    Mukadder Orhan Sungur

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Sungur, Z., Şentürk, M. (2017). Should Every “Myasthenic Thymectomy” Be Sent to ICU?. In: Şentürk, M., Orhan Sungur, M. (eds) Postoperative Care in Thoracic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-19908-5_8

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  • DOI: https://doi.org/10.1007/978-3-319-19908-5_8

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  • Online ISBN: 978-3-319-19908-5

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