Hypotension Prolonged in a Patient with Myasthenia Gravis after Epidural Anesthesia

Abstract

Myasthenia gravis is a chronic autoimmune disease characterized by progressive weakness and easy fatigability of voluntary skeletal muscles. Clinicians are well aware of the risk of postoperative respiratory failure that may result from stress-induced exacerbation of Myasthenia gravis (myasthenic crisis), an overdose of anticholinesterases (cholinergic crisis), the residual effects of myorelaxants or other adverse drug interactions (with antibiotics or antiarrhythmics). Therefore, routine postoperative ventilatory support and planned extubation in the intensive care unit have been recommended in high-risk patients. However, regional anesthesia have been suggested for the lower abdominal and extremity operations. We wanted to report our case observing severe hypotension during and after operation in the patient with myasthenia gravis performing epidural anesthesia for radical prostatectomy

Keywords

• myasthenia gravis,epidural anesthesia,hypotension

Epidural Anestezi Sonrası Myastenia Gravis’li Bir Hastada Uzun Süren Hipotansiyon

Abstract

Myastenia gravis istemli iskelet kaslarında ilerleyici kas zayıflığı ve kolay yorulma ile katekterize kronik otoimmun bir hastalıktır. Klinisyenler aşırı antikolinesteraz dozu (kolinerjik kriz), kas gevşeticilerin ya da diğer ilaç etkileşimlerine bağlı (antibiyotik veya antiaritmikler) residüal etkilerine bağlı MG krizini tetikleyerek postoperatif solunum yetmezliği riski oluşturabileceğinden dikkatli olmalıdırlar. Bundan dolayı yüksek riskli hastalarda, rutin ventilatör ve yoğun bakım desteği önerilmektedir. Ancak alt batın ve ekstremite ameliyatları için rejyonel anestezi tercihi yapılmaktadır. Radikal prostatektomi için epidural anestezi uygulanan Myastenia gravis’li bir hastada operasyon sırasında ve sonrasında dirençli hipotansiyon gelişen olguyu sunmak istedik

Keywords

• myastenia gravis,epidural anestezi,hipotansiyon

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