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http://dx.doi.org/10.17245/jdapm.2019.19.1.67

Anesthetic considerations for a patient with myasthenia gravis undergoing deep sedation in an outpatient oral surgery setting  

Prabhu, Shamit S. (Triangle Implant Center)
Khan, Saad A. (Triangle Implant Center)
Doudnikoff, Alexander L. (Triangle Implant Center)
Reebye, Uday N. (Triangle Implant Center)
Publication Information
Journal of Dental Anesthesia and Pain Medicine / v.19, no.1, 2019 , pp. 67-72 More about this Journal
Abstract
Myasthenia gravis (MG) is a neuromuscular autoimmune disorder which clinically presents as muscular weakness and fatigue due to autoantibody formation against acetylcholine receptors (AChR), leading to their subsequent destruction. Due to the neuromuscular implications of MG, certain considerations must be taken into account when providing anesthesia to MG patients. In the following case report, we have outlined procedural considerations for the anesthetic management of a patient with MG undergoing deep sedation for an elective oral surgery in an outpatient setting, as well as a discussion of relevant literature.
Keywords
Anesthesia; Myasthenia Gravis; Oral Surgery;
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1 Tamburrini A, Tacconi F, Barlattani A, C Mineo T. An update on myasthenia gravis, challenging disease for the dental profession. J Oral Sci 2015; 57: 161-8.   DOI
2 Keesey JC. Clinical evaluation and management of myasthenia gravis. Muscle Nerve 2004; 29: 484-505.   DOI
3 Thavasothy M, Hirsch N. Myasthenia gravis. BJA CEPD Reviews 2002; 2:88-90. Available from: http://dx.doi.org/10.1093/bjacepd/2.3.88   DOI
4 Wendell LC, Levine JM. Myasthenic crisis. Neurohospitalist 2011; 1: 16-22.   DOI
5 Gilhus NE. Myasthenia Gravis. N Engl J Med 2016; 375: 2570-81.   DOI
6 Drachman DB. Myasthenia Gravis. N Engl J Med 1994; 330: 1797-810.   DOI
7 Ha JC, Richman DP. Myasthenia gravis and related disorders: Pathology and molecular pathogenesis. Biochim Biophys Acta 2015; 1852: 651-7.   DOI
8 Daroff RB. The office Tensilon test for ocular myasthenia gravis. Arch Neurol 1986; 43: 843-4.   DOI
9 Jamal BT, Herb K. Perioperative management of patients with myasthenia gravis: Prevention, recognition, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 612-5.   DOI
10 Osserman K. Myasthenia Gravis. Grune & Stratton. 1958. p. 78-80.
11 Fukayama H. Which Is Better-Conscious Sedation or Deep Sedation? Anesth Prog 1995; 42: 100-2.   DOI
12 Yarom N, Barnea E, Nissan J, Gorsky M. Dental management of patients with myasthenia gravis: A literature review. Oral Surgery Oral Med Oral Pathol Oral Radiol Endodontology 2005; 100: 158-63.   DOI
13 Patil PM, Singh G, Patil SP. Dentistry and the myasthenia gravis patient: A review of the current state of the art. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114: e1-8.   DOI
14 Abel M, Eisenkraft JB. Anesthetic implications of myasthenia gravis. Mt Sinai J Med 2002; 69: 31-7.
15 Ceremuga TE, Yao XL, McCabe JT. Etiology, mechanisms, and anesthesia implications of autoimmune myasthenia gravis. AANA J 2002; 70: 301-10.
16 Muckler VC, O'Brien JM, Matson SE, Rice AN. Perianesthetic implications and considerations for myasthenia gravis. J Perianesth Nurs 2019; 34: 4-15.   DOI