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   Anesthetic Management of Simultaneous Coronary Artery bypass Grafting with Cardiopulmonary bypass and Extended Thymectomy in a Patient with Myasthenia Gravis  
   
نویسنده Massad Islam M ,Dumour Elias A ,Abeeleh Mahmoud Abu ,Al-Smady Moaath
منبع jordan medical journal - 2014 - دوره : 48 - شماره : 3 - صفحه:171 -180
چکیده    A 61-yr-old male having myasthenia gravis mg (osserman iib), hypertension htn, hyperlipidemia, type ii diabetes mellitus dm ii, a single pelvic kidney, chronic obstructive pulmonary disease copd with a positive history of smoking and coronary artery disease, was admitted for uncontrolled myasthenic symptoms, cardiology team was consulted, cardiac catheterization was performed and revealed a three vessel coronary artery disease. all the findings dictated the management, a combined coronary artery bypass graft cabg and an extended thymectomy was performed. optimization of the patient was achieved preoperatively. total intravenous anesthesia using propofol and remifentanyl was applied to this patient. continuous monitoring of the neuromuscular transmission nmt was maintained throughout the perioperative period. although neither muscle relaxants nor inhalational agents were used in the anesthetic management of this patient; the patient developed postoperative atelectasis and lung collapse; which was managed successfully, and extubation of the trachea was done after ensuring adequate recovery of the nmt and respiratory function. myasthenic therapy was continued throughout the perioperative period.
کلیدواژه Myasthenia gravis; Coronary artery bypass grafting; Cardiopulmonary bypass; Perioperative management
آدرس University of Jordan, Jordan University Hospital, Faculty of Medicine, Department of Anesthesia and Intensive Care, Jordan, University of Jordan, Jordan University Hospital, Faculty of Medicine, Department of Anesthesia and Intensive Care, Jordan, University of Jordan, Faculty of Medicine, Jordan University Hospital, Department of General Surgery, Jordan, University of Jordan, Faculty of Medicine, Jordan University Hospital, Department of General Surgery, Jordan
 
     
   
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