El-Dawlatly Abdelazeem A
College of Medicine, King Saud Univ., Riyadh, KSA.
Middle East J Anaesthesiol. 2007 Feb;19(1):219-24.
Anesthesia for thymectomy in myasthenia gravis is challenging. The anesthetic experience of that technique is quite large. In involves either muscle relaxant or non-muscle relaxant techniques. However, the literature is deficient of standard anesthetic technique for thoracoscopic thymectomy. Therefore we present in this report a modified non-muscle relaxant technique for thoracoscopic thymectomy (TT). We report two cases who underwent TT under general anesthesia using sufentanil and propofol for induction and local anesthesia spray to the vocal cords to facilitate endobronchial intubation using non-muscle relaxant technique. The intubating, operating and postoperative conditions were excellent. To the best of our knowledge, this is the first report on modified non-muscle relaxant technique for TT in myasthenia gravis. Further cases have to be done to verify our technique.
重症肌无力患者胸腺切除术的麻醉具有挑战性。该技术的麻醉经验要求颇高。它涉及肌肉松弛剂或非肌肉松弛剂技术。然而,文献中缺乏用于胸腔镜胸腺切除术的标准麻醉技术。因此,我们在本报告中介绍一种用于胸腔镜胸腺切除术(TT)的改良非肌肉松弛剂技术。我们报告了两例在全身麻醉下接受TT的病例,诱导时使用舒芬太尼和丙泊酚,通过向声带喷洒局部麻醉剂以利于使用非肌肉松弛剂技术进行支气管内插管。插管、手术及术后情况均良好。据我们所知,这是关于重症肌无力患者TT改良非肌肉松弛剂技术的首例报告。还需进行更多病例以验证我们的技术。