Laparoscopic sleeve gastrectomy in a morbidly obese patient with myasthenia gravis

A review of the management

Megana Ballal, Tracey Straker

Research output: Contribution to journalReview article

Abstract

Myasthenia gravis, a disorder of neuromuscular transmission, presents a unique challenge to the perioperative anesthetic management of morbidly obese patients. This report describes the case of a 27-year-old morbidly obese woman with a past medical history significant for myasthenia gravis and fatty liver disease undergoing bariatric surgery. Anesthesia was induced with intravenous agents and maintained with an inhalational and balanced intravenous technique. The nondepolarizing neuromuscular blocker Cisatracurium was chosen so that no reversal agents were given. Neostigmine was not used to antagonize the effects of Cisatracurium. The goal of this approach was to reduce the risk of complications such as postoperative mechanical ventilation. The anesthetic and surgical techniques used resulted in an uneventful hospital course. Therefore, we can minimize perioperative risks and complications by adjusting the anesthetic plan based on the patient's physiology and comorbidities as well as the pharmacology of the drugs.

Original languageEnglish (US)
Article number593586
JournalCase Reports in Medicine
Volume2015
DOIs
StatePublished - 2015

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Myasthenia Gravis
Gastrectomy
Anesthetics
Neuromuscular Junction Diseases
Neuromuscular Nondepolarizing Agents
Neuromuscular Blocking Agents
Neostigmine
Bariatric Surgery
Fatty Liver
Artificial Respiration
Comorbidity
Liver Diseases
Anesthesia
Pharmacology
Pharmaceutical Preparations
cisatracurium

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Laparoscopic sleeve gastrectomy in a morbidly obese patient with myasthenia gravis : A review of the management. / Ballal, Megana; Straker, Tracey.

In: Case Reports in Medicine, Vol. 2015, 593586, 2015.

Research output: Contribution to journalReview article

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