Anaesthetic management in a known case of myasthenia gravis posted for sternotomy with thymectomy

Abstract

Myasthenia gravis (MG) is a chronic disorder of the neuromuscular junction. It is characterized by circulating antibodies against the acetylcholine receptors resulting in a decrease in the functional acetylcholine receptors at the neuromuscular junction. Hence the anaesthetic management is challenging in these cases due to unpredictable susceptibility of acetylcholine receptors to muscle relaxants. In this case report, we are describing the successful anaesthetic management of a patient with myasthenia gravis undergoing sternotomy with thymectomy for a swelling on left side of the neck. We concluded that it is possible to provide anaesthesia and pain relief without the use of skeletal muscle relaxants during general anaesthesia and without the need of prolonged postoperative ventilation in a patient of MG.