Walz R, Lübbe N, Walz K, Mahr K H
Abteilung I, Medizinischen Hochschule Hannover.
Anaesthesiol Reanim. 1996;21(2):43-6.
This report concerns a narcosis in a 42-year-old female patient suffering from myasthenia gravis in a state of clinical remission after thymectomia. Six months after thymectomia relaxometric control (Datex AMG) was performed while the patient underwent major colorectal surgery. We found a persisting sensitivity to relaxants during isoflurane anaesthesia supplemented with fentanyl. During 270 minutes of anaesthesia we needed only 25 mg atracurium (0.4 mg/kg bodyweight) only 57% of a theoretical normal dose. This is the result of a continuing muscular weakness in asymptomatic patients suffering from clinically reliable myasthenia gravis. Therefore, a reduced demand for muscle relaxants can be expected in these patients.
本报告涉及一名42岁患有重症肌无力的女性患者，该患者在胸腺切除术后处于临床缓解状态。胸腺切除术后六个月，在患者接受大肠大手术期间进行了松弛度监测（Datex AMG）。我们发现在异氟烷麻醉并辅以芬太尼的过程中，患者对肌肉松弛剂仍持续敏感。在270分钟的麻醉过程中，我们仅需要25毫克阿曲库铵（0.4毫克/千克体重），仅为理论正常剂量的57%。这是患有临床确诊的重症肌无力的无症状患者持续存在肌肉无力的结果。因此，预计这些患者对肌肉松弛剂的需求会减少。
