Trans-sternal Thymectomy in Myasthenia Gravis Patients with Laryngeal Mask Airway. | [Journal of Surgery Pakistan • 2012]

Author(s):

1. Erum Zeb: Department of Anaesthesia, Pain Management & Surgical Intensive Care Unit, Jinnah Postgraduate Medical Centre, Karachi, Pakistan

2. Nasir Khan Jakhrani: Department of Anaesthesia Pain Management & Surgical Intensive Care Unit, Jinnah Postgraduate Medical Centre, Karachi, Pakistan

3. Shahneela Raza: Department of Anaesthesia Pain Management & Surgical Intensive Care Unit, Jinnah Postgraduate Medical Centre, Karachi, Pakistan

4. Roohina N. Baloch: Department of Anaesthesia Pain Management & Surgical Intensive Care Unit, Jinnah Postgraduate Medical Centre, Karachi, Pakistan

Abstract:

Objective: To demonstrate the safety and efficacy of laryngeal mask airway (Proseal™) in patients undergoing trans-sternal thymectomy for myasthenia gravis. Study design: A descriptive case series. Place & Duration of study: Department of Anaesthesia, Jinnah Postgraduate Medical Centre Karachi, from June 2006 to December 2010. Methodology: All patients who underwent trans-sternal thymectomy for myasthenia gravis under laryngeal mask airway (Proseal™) were included. They were maintained with inhalation agent and analgesics. Muscle relaxants were avoided in all the patients. The haemodynamics and blood gases were monitored peri operativel y. Results: A total of sixteen patients underwent the procedure using laryngeal mask airway (Proseal™). There were ten females and 6 males. Mean age at presentation was 26.5±10.4 year. The haemodynamics and blood gases were well maintained perioperatively. Fourteen patients (87.5%) could be extubated successfully. Two patients needed intubation and ventilation; one for 9 hours and other for 24 hours. These patients were identified as those who were on higher doses of pyridostigmine (>240 mg) and had severe pre-operative muscle weakness. Conclusion: The use of laryngeal mask airway (Proseal™) for patients undergoing trans-sternal thymectomy is a satisfactory alternative to tracheal intubation for those patients of myasthenia gravis who do not require airway protection. Avoidance of muscle relaxants and use of laryngeal mask airway (proseal™) in facilitate rapid emergence and allowed early extubation.

Page(s): 98-102

DOI: DOI not available

Published: Journal: Journal of Surgery Pakistan, Volume: 17, Issue: 3, Year: 2012

Keywords:

Keywords are not available for this article.

References:

References are not available for this document.

Citations

Citations are not available for this document.

Citations

Downloads

Views