Anesthetic Management of a Patient With Antimuscle-Specific Kinase Antibody-Positive Myasthenia Gravis Undergoing an Open Cholecystectomy: A Case Report.

M. Akatsu, Y. Ikegami, C. Tase, K. Nishikawa
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引用次数: 4

Abstract

Myasthenia gravis (MG) is an autoimmune disease characterized by the production of antibodies against the acetylcholine receptor, muscle-specific kinase (MuSK), or other proteins at the neuromuscular junction. MG with antibodies against MuSK (MuSK-MG) has been described recently. Here, we report the first case of anesthetic management of a patient with MuSK-MG undergoing an open cholecystectomy. In our case, propofol and remifentanil-based anesthesia were used for successful management without using muscle relaxants. Patients with MuSK-MG have predominantly ocular, bulbar, and respiratory symptoms that may increase the risk of aspiration. Anesthesiologists need to pay attention to perioperative respiratory failure and respiratory crisis.
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1例抗肌肉特异性激酶抗体阳性重症肌无力开放性胆囊切除术患者的麻醉处理
重症肌无力(MG)是一种自身免疫性疾病,其特征是在神经肌肉连接处产生针对乙酰胆碱受体、肌肉特异性激酶(MuSK)或其他蛋白质的抗体。具有MuSK抗体的MG (MuSK-MG)是最近才被报道的。在这里,我们报告第一例麻醉管理的病人麝香mg接受开放胆囊切除术。在我们的病例中,我们成功地使用了异丙酚和瑞芬太尼为基础的麻醉,而没有使用肌肉松弛剂。麝香- mg患者主要表现为眼部、球部和呼吸道症状,可能增加误吸的风险。麻醉医师需要注意围手术期呼吸衰竭和呼吸危象。
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