Ahmet BİLEN, Dalokay KILIÇ, Suat Özer ÖNER, Nusa TUNA, Ayda TÜRKÖZ

Timektomi uygulanan miyastenia gravis'li olguda laringeal maske (Olgu sunumu)

Miyastenia Gravis (MG) nöromüsküler kavşakta asetilkolin reseptörlerinin azalması ile karakterize otoimmün bir hastalıktır. Kas gevşeticilere duyarlılık arttığı için anestezi uygulamalarında kas gevşetici kullanılmasından kaçınılması önerilmektedir. Laringeal maske (LMA), kas gevşeticiye ihtiyaç olmaması ve hava yolu komplikasyonlan insidansmın düşük olması nedeniyle endotrakeal entübasyona tercih edilmektedir. MG'li hastalarda inhalasyon ajanları nöromüsküler kavşağı etkiledikleri için intravenöz anesteziklerin inhalasyon ajanlarına üstün olduğu kabul edilmektedir. Bu sunumda, Miyastenia gravis-Osserman II-B olan ve transsternal timektomi operasyonu için propofol-remifentanil ile kas gevşeticisiz LMA uygulanması tartışılmıştır.

Anahtar Kelimeler:

Timektomi, Miyastenia gravis, Larinks maskeleri, Anestezikler

Laryngeal mask airway administration for thymectomy of a myasthenia gravis patient (Case report)

Myasthenia Gravis (MG) is an autuoimmun disease characterized by decreased acetylcholine reseptors on neuromuscular junction. Because the sensitivity of neuromuscular blocking (NMB) agents is increased, avoidance of NMB agents usage in anesthesia practice is suggested in that disease. Unnecessity for NMB agents and low incidence ofairway complications make laryngeal mask airway (LMA) preferable to endotracheal intubation. As U is known that inhalational agents are affecting the neuromuscular junction, intravenous anesthetics are superior in MG. in this report, we present a MG Osserman II-B patient and LMA administration, using propofol-remifentanil vithout NMB agents, for transsternal thymectomy operation.

Keywords:

Thymectomy, Myasthenia Gravis, Laryngeal Masks, Anesthetics,

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