Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi, cilt.32, sa.5, ss.395-399, 2004 (Scopus)
Myasthenia gravis is an autoimmune disorder characterized by inactivation or reduction of the postsynaptic acetylcholine receptors in the neuromuscular junction by IgG antibodies. One major problem for the anaesthesiologist involves the use of muscle relaxants in these patients. The myasthenic patient is typically sensitive to nondepolarizing neuromuscular blockers and shows resistance to depolarizing agents. The use of nondepolarizing agents in patients with myasthenia gravis, even in small doses for priming or defasciculation, results in respiratory depression that requires assisted ventilation and monitorization postoperatively. Several general anaesthetic techniques have been reported, although non has been proven to be superior to the others. There are few reports regarding the use of propofol and remifentanil in myasthenics as total intravenous anaesthesia without using muscle relaxants. In this report we aimed to discuss the anesthetic management of a patient with myasthenia gravis undergoing diagnostic laparoscopy under total intravenous anaesthesia.