| Popis: |
Myasthenia gravis is the result of autoimmune antibodies targeted against acetylcholine receptors on postsynaptic membranes of the neuromuscular junction. The majority of patients will describe drooping of the eyelids and blurred vision as their initial symptoms with worsening weakness associated with continued muscle use. Typically treated with pyridostigmine, other options such as intravenous immunoglobulin and plasmapheresis, exist for severe symptoms associated with myasthenic syndrome. The anesthetic plan must be thoughtfully considered, taking into account premedication, induction agents, and neuromuscular blocking drugs administered. Most importantly, extubation must be done in a well-planned manner to ensure adequate neuromuscular function to allow appropriate ventilation. |
