Martinelli Susan M, Lateef Bilal D, Long Jason M, Huang David Y, Karmarkar Ameeta, Barrick Brian P
From the Departments of *Anesthesiology, †Surgery, and ‡Neurology, University of North Carolina, UNC Hospitals, Chapel Hill, North Carolina.
A A Case Rep. 2017 May 1;8(9):222-225. doi: 10.1213/XAA.0000000000000471.
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.
我们描述了一例重症肌无力患者接受机器人辅助胸腺切除术并并发术后重症肌无力危象的病例，重点关注该病例特有的麻醉注意事项。由于重症肌无力是一种影响乙酰胆碱受体的自身免疫性疾病，使用神经肌肉阻滞剂及其逆转剂时必须谨慎。鉴于机器人对接时患者移动的风险、肺隔离、拔管标准及术后处置等因素，采用机器人辅助手术方法会使麻醉管理具有挑战性。
