Berlin Medical Journal

Myasthenia gravis is a rare autoimmune disease whose surgical treatment is thymectomy. The video-assisted thoracoscopic surgical procedure offers significant advantages over thoractomy 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 Anästhesie, original papers and case reports from various publications in the Berlin Medical Journal are compiled, which impressively demonstrate the scientific experience potential of perioperative management. With an impressive number of perioperative treatments, the authors compile reports of 81 patients from 4 months, which represents a disproportionately frequent treatment in view of the disease incidence of 3-4:1,000,000. Perioperatively, the application of propofol as a TCI module was shown to have advantages over inhaled anaesthesia and TIVA application. The neuromuscular blockade required for the surgical intervention can be used with cisatracurium as a TIVA without relevant restrictions during the anaesthesia period if the dose is reduced and neuromuscular monitoring is intensified.
Postoperatively, the TIVA application of short-acting but effective opioids such as remifentanil can be used sufficiently and competently.