{"id":2181,"date":"2013-08-23T07:58:44","date_gmt":"2013-08-23T07:58:44","guid":{"rendered":"http:\/\/test-medrazgl.aed-baza.si\/?p=2181"},"modified":"2013-08-23T08:00:15","modified_gmt":"2013-08-23T08:00:15","slug":"anaesthesia-in-patients-with-myasthenia-gravis","status":"publish","type":"post","link":"https:\/\/medrazgl.si\/en\/anaesthesia-in-patients-with-myasthenia-gravis\/","title":{"rendered":"Anaesthesia in Patients with Myasthenia Gravis"},"content":{"rendered":"<div>\n<p>Myasthenia gravis is an autoimmune disorder of the motor plate. The degree of reduction in the number of functional acetylcholine receptors correlates with the severity of myasthenia gravis as manifested by increasing weakness and fatigue of skeletal muscles. Medical treatment of myas\u00adthenia gravis includes improvement of neuromuscular transmission by anticholinesterases, suppression of the immune system with the use of corticosteroids and immunosuppressive drugs and reduction of the amount of circulating antibodies by plasmapheresis. Myasthenia gravis is frequently associated with an abnormality of the thymus. Transsternal thymectomy reduces the required doses of anticholinesterases and immunosuppressants. This paper presents the anes\u00adthetic management of patients with myasthenia gravis. The anesthetic management of a patient with myasthenia gravis undergoing transsternal thymectomy is also described. This patient received a combination of high thoracic epidural anaesthesia with 0.5% bupivacaine and fentanyl and total intravenous anaesthesia with propofol and remifentanyl. Our experience shows that a com\u00adbination of high thoracic epidural anesthesia and total intravenous anesthesia is an appropriate anesthetic technique for transsternal thymectomy and ensures good hemodynamic stability dur\u00ading surgery, uneventful recovery and effective post-operative analgesia.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Myasthenia gravis is an autoimmune disorder of the motor plate. The degree of reduction in the number of functional acetylcholine receptors correlates with the severity of myasthenia gravis as manifested by increasing weakness and fatigue of skeletal muscles. Medical treatment of myas\u00adthenia gravis includes improvement of neuromuscular transmission by anticholinesterases, suppression of the immune system [&hellip;]<\/p>\n","protected":false},"author":19,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[355,426],"tags":[],"class_list":["post-2181","post","type-post","status-publish","format-standard","hentry","category-2-2003-archive","category-internal-medicine"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Anaesthesia in Patients with Myasthenia Gravis - Dru\u0161tvo Medicinski razgledi<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medrazgl.si\/anestezija-pri-bolniku-z-miastenijo-gravis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Anaesthesia in Patients with Myasthenia Gravis - Dru\u0161tvo Medicinski razgledi\" \/>\n<meta property=\"og:description\" content=\"Myasthenia gravis is an autoimmune disorder of the motor plate. The degree of reduction in the number of functional acetylcholine receptors correlates with the severity of myasthenia gravis as manifested by increasing weakness and fatigue of skeletal muscles. Medical treatment of myas\u00adthenia gravis includes improvement of neuromuscular transmission by anticholinesterases, suppression of the immune system [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/medrazgl.si\/anestezija-pri-bolniku-z-miastenijo-gravis\/\" \/>\n<meta property=\"og:site_name\" content=\"Dru\u0161tvo Medicinski razgledi\" \/>\n<meta property=\"article:published_time\" content=\"2013-08-23T07:58:44+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2013-08-23T08:00:15+00:00\" \/>\n<meta name=\"author\" content=\"\u0160pela Tev\u017ei\u010d\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\u0160pela Tev\u017ei\u010d\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/medrazgl.si\\\/anestezija-pri-bolniku-z-miastenijo-gravis\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/medrazgl.si\\\/anestezija-pri-bolniku-z-miastenijo-gravis\\\/\"},\"author\":{\"name\":\"\u0160pela Tev\u017ei\u010d\",\"@id\":\"https:\\\/\\\/medrazgl.si\\\/#\\\/schema\\\/person\\\/a9c9f729f51105c2bf5cb24afcf1beb2\"},\"headline\":\"Anaesthesia in Patients with Myasthenia Gravis\",\"datePublished\":\"2013-08-23T07:58:44+00:00\",\"dateModified\":\"2013-08-23T08:00:15+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/medrazgl.si\\\/anestezija-pri-bolniku-z-miastenijo-gravis\\\/\"},\"wordCount\":188,\"commentCount\":0,\"articleSection\":[\"2\",\"Internal Medicine\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/medrazgl.si\\\/anestezija-pri-bolniku-z-miastenijo-gravis\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/medrazgl.si\\\/anestezija-pri-bolniku-z-miastenijo-gravis\\\/\",\"url\":\"https:\\\/\\\/medrazgl.si\\\/anestezija-pri-bolniku-z-miastenijo-gravis\\\/\",\"name\":\"Anaesthesia in Patients with Myasthenia Gravis - 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