Anesthetic Management of a Patient With Antimuscle-Specific Kinase Antibody-Positive Myasthenia Gravis Undergoing an Open Cholecystectomy: A Case Report.
作者信息
Akatsu Masahiko, Ikegami Yukihiro, Tase Choichiro, Nishikawa Koichi
机构信息
From the *Department of Anesthesiology, Iwaki Kyoritsu Hospital, Fukushima, Japan; †Department of Disaster and Comprehensive Medicine, Fukushima Medical University, Fukushima, Japan; ‡Department of Anesthesiology, Fukushima Medical University School of Medicine, Fukushima, Japan; and §Department of Emergency and Critical Care Medicine, Fukushima Medical University, Fukushima, Japan.
出版信息
A A Case Rep. 2017 Mar 15;8(6):150-153. doi: 10.1213/XAA.0000000000000453.
Myasthenia gravis (MG) is an autoimmune disease characterized by the production of antibodies against the acetylcholine receptor, muscle-specific kinase (MuSK), or other proteins at the neuromuscular junction. MG with antibodies against MuSK (MuSK-MG) has been described recently. Here, we report the first case of anesthetic management of a patient with MuSK-MG undergoing an open cholecystectomy. In our case, propofol and remifentanil-based anesthesia were used for successful management without using muscle relaxants. Patients with MuSK-MG have predominantly ocular, bulbar, and respiratory symptoms that may increase the risk of aspiration. Anesthesiologists need to pay attention to perioperative respiratory failure and respiratory crisis.
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