Journal Anesthesia

DOI:10.36210/BerMedJ/epub662024

Abstract

Myasthenia gravis is a rare autoimmune disease whose surgical treatment consists of thymectomy. The video-assisted thoracoscopic surgical procedure offers significant advantages over thoracotomy in the perioperative management of patients. Within myasthenia gravis, the juvenile forms of the disease are particularly suitable for video-assisted surgery and are readily accepted by the mostly female children. In the journal Anesthesia, original papers and case reports are compiled from various publications in the Berlin Medical Journal, which impressively demonstrate the scientific potential of perioperative management. With an impressive number of perioperative treatments, the authors compile reports from 81 patients over 4 months, which is particularly impressive given the frequency of the disease 3-4:1,000,000 represents a disproportionately frequent treatment. Perioperatively, it was shown that the application of propofol as a TCI module has advantages over inhalational anesthesia and TIVA application. The necessary neuromuscular blockade for the surgical intervention can be used with cisatracurium as TIVA without relevant restrictions in the anesthesia time if a dose reduction is carried out and intensified neuromuscular monitoring is carried out. Postoperatively, TIVA application of short-acting but effective opioids such as remifentanil can be used sufficiently and without complications.