THYMECTOMY IN MYASTHENIA GRAVIS

ANAESTHETIC MANAGEMENT WITH PROPOFOLTRAMADOL WITHOUT MUSCLE RELAXANTS ALLOWS EARLY EXTUBATION.

Abstract

Background Anaesthetic management for thymectomy in myasthenia gravis (MG) presents a significant challenge to the anesthesiologist due to neuromuscular involvement. One of the recommended techniques of general anaesthesia is to avoid the use of muscle relaxants and rely on propofol anaesthesia or a combination of propofol and an analgesic. Objectives: This study was undertaken to investigate the efficacy and safety of propofol-tramadol anaesthesia for transsternal thymectomy in MG and to find out whether it allows early extubation. Design of Study: Quasiexperimental/ before-after type Setting: PMC, District Headquarter Hospital, Faisalabad. Period: From February 2004 to July 2005 Methods: Twelve consecutive myasthenic patients undergoing transsternal thymectomy were included in this study based on temporal sampling. Anaesthesia was induced with propofol-tramadol, without muscle relaxants and maintained with propofol infusion and toradol and tramadol boluses as required, together with ventilation with oxygen and nitrous-oxide. Results: Propofoltramadol anaesthesia allowed early extubation of all the patients without any anaesthesia related complications. Conclusions: Propofol-tramadol anaesthesia is safe and allows early extubation.