Anesthetic management of a patient with myasthenia gravis during hypothermic cardiopulmonary bypass.

The anesthetic management of a patient with myasthenia gravis (MG) who underwent cardiac surgery with hypothermic cardiopulmonary bypass (CPB) is described. Using total intravenous anesthesia with propofol and a moderate dose fentanyl, the variations of neuromuscular function and serum anti-acetylcholine receptor antibody concentration were examined in relation to hypothermic CPB in the absence of muscle relaxants. The anesthetic technique used may have helped to avoid the risks incidental to muscle relaxants in this patient with MG undergoing hypothermic CPB.