Saudi Journal of Anaesthesia

EDITORIAL
Year
: 2011  |  Volume : 5  |  Issue : 1  |  Page : 1-

Anesthesia for thymectomy


Abdelazeem El-Dawlatly 
 Professor of Anaesthesia, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Correspondence Address:
Abdelazeem El-Dawlatly
Professor of Anaesthesia, College of Medicine, King Saud University, Riyadh
Saudi Arabia




How to cite this article:
El-Dawlatly A. Anesthesia for thymectomy.Saudi J Anaesth 2011;5:1-1


How to cite this URL:
El-Dawlatly A. Anesthesia for thymectomy. Saudi J Anaesth [serial online] 2011 [cited 2022 Aug 7 ];5:1-1
Available from: https://www.saudija.org/text.asp?2011/5/1/1/76465


Full Text

Anesthesia for thymectomy in patients with myasthenia gravis is challenging. Myasthenia gravis is an autoimmune neuromuscular disease affecting the postsynaptic acetylcholine receptors that are blocked by specific antibodies, with resultant muscle weakness and fatigue. Anesthesia for thymectomy can be classified into: muscle relaxant or nonmuscle relaxant techniques. Our description of the nonmuscle relaxant technique retuned back to 1994, when it was first described. [1] The technique included insertion of a thoracic epidural catheter in an awake patient followed by induction of anesthesia using propofol and fentanyl. Tracheal intubation was facilitated with spraying the vocal cords with 3 ml of 4% xylocaine and maintenance of anesthesia was achieved with oxygen in air and 10-15 ml of 2% propofol as continuous i.v. infusion drip. Our nonmuscle relaxant technique has got wide acceptance and was verified in many subsequent studies worldwide. [2],[3] In this issue of Saudi J Anesthesia, Stephenson et al. further described a nonmuscle relaxant technique for trans-sternal thymectomy in patients with juvenile myasthenia gravis with satisfactory outcome results. [4] We believe that the use of a nonmuscle relaxant anesthetic technique for trans-sternal thymectomy provides excellent intra- and postoperative conditions. Recently, thoracoscopic thymectomy has got wide acceptance among surgeons. In that regard, we have described a modified anesthetic technique that we believe is suitable for thoracoscopic thymectomy with excellent outcome results. [5]

References

1El-Dawlatly AA, Ashour MH. Anaesthesia for thymectomy in myasthenia gravis: a non-muscle-relaxant technique. Anaesth Intensive Care 1994;22:458-60.
2Bogaert F, Verhaeghen D, Herregods L. Myasthenia gravis and thymectomy: an anaesthetic approach. Acta Anaesthesiol Belg 2007;58:185-90.
3Chan MT, Ng SK, Low JM. A non-muscle-relaxant technique for video-assisted thoracoscopic thymectomy in myasthenia gravis. Anaesth Intensive Care 1995;23:256-7.
4Stephenson LL, Tkachenko I, Shamberger RC, Seefelder C. Anesthesia for patients undergoing transsternal thymectomy for juvenile myasthenia gravis. Saudi J Anaesth; 2011;5:25-30.
5El-Dawlatly A. Anaesthesia for thoracoscopic thymectomy: modified non-muscle relaxant technique. Middle East J Anesthesiol 2007;19:219-24.