Anaesthetic Management of a Patient with Myasthenia Gravis for Laparascopic Cholecystectomy: A Case Report

Abstract

Myasthenia gravis is an autoimmune disease, which presents as fatigue and muscle weakness due to destruction of nicotinic receptors. Perioperative management of such patients is challenging due to altered pharmacology of drugs especially muscle relaxants and opioids as well as high incidence of postoperative respiratory complications. Here, authors report a new anaesthetic technique for avoiding muscle relaxants and opioids in a myasthenia gravis patient using a combination of total intravenous anaesthesia with bilateral subcostal Transverses Abdominis Plane (TAP) block.

Keywords

• dexmedetomidine
• muscle relaxants
• subcostal transversus abdominis plane block