重症肌无力患者在深低温停循环下行全主动脉弓置换术的麻醉管理
Anesthetic Management of Total Aortic Arch Replacement in a Myasthenia Gravis Patient under Deep Hypothermic Circulatory Arrest.
作者信息
Kondo Mamiko, Yoshikawa Yusuke, Terada Hirofumi, Yamakage Michiaki
机构信息
Department of Anesthesiology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan.
出版信息
Case Rep Anesthesiol. 2019 Jul 4;2019:3278147. doi: 10.1155/2019/3278147. eCollection 2019.
Abstract
The anesthetic management of myasthenia gravis patients undergoing cardiac or aortic surgery under cardiopulmonary bypass, especially with deep hypothermic circulatory arrest, is challenging. We describe a case of successful anesthetic management of a myasthenia gravis patient undergoing total arch replacement with deep hypothermic circulatory arrest under neuromuscular monitoring and complete reversal of the action of neuromuscular blocking drugs by sugammadex. The present case suggests that patients with well-controlled myasthenia gravis might be safely managed in cardiac or aortic surgery under cardiopulmonary bypass with deep hypothermic circulatory arrest.
摘要
对接受体外循环下心脏或主动脉手术（尤其是深低温停循环）的重症肌无力患者进行麻醉管理具有挑战性。我们描述了一例重症肌无力患者在神经肌肉监测下接受全弓置换并在深低温停循环状态下成功进行麻醉管理的病例，术中使用舒更葡糖完全逆转了神经肌肉阻滞药物的作用。本病例表明，病情得到良好控制的重症肌无力患者在体外循环下心脏或主动脉手术中采用深低温停循环时可能得到安全管理。
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