Anesthesia without muscular relaxants and univent tube intubation for thoracoscopic thymectomy in my asthenia gravis patients
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Abstract
90 MG patients (class I, IIA, IIB – according to the clacssification of Perlo- Ossermann) undergoing thoracoscopic thymectomy randomly divided into 2 groups. Propofol TCI group (45 patients) were anesthetized with propofol TCI and sevoflurane group (45 patients) were anesthetized with sevoflurane.
1. Both methods of induction by sufentanil (0.5µg/kg) with propofol TCI (Ce: 5μg/ml) or MCI (inject by hand) (2 to 2.5mg/kg) had a good and safe anesthetic effect. All patients were intubated Univent tubes successfully.
2. Sufentanil was infused with the rate of 0.2μg/kg/h in combination with propofol TCI (Ce = 3.5-4.5μg/ml) or with sevoflurane (1-1.5MAC) to ensure effective and safe anesthesia. Hemodynamic and respiratory funtion were maintained stabitility. Surgeons were satisfied with the anesthesia method applied in both groups.
3. All the patients met the criteria for extubation immediately at the end of surgery in the operating room. Respiratory funtion for the first 72 hours after surgery was normal. Airway injuries (21.11%) including sore throat and hoarseness. Lesions were determine through laryngotracheal endoscopic include: congestion and edema. The lesions of the airway were mild, narrow and lasted no longer than 3 days postoperative.
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Keywords
Mysthenia gravis, propofol TCI, sevoflurane, muscle relaxant.
References
2. Phạm Văn Đông, Nguyễn Thị Thảo Trang (2014), Gây mê hồi sức trong mổ cắt u tuyến ức điều trị bệnh nhược cơ tại bệnh viên Chợ Rẫy từ năm 2004-2012, Tạp chí Y học thực hành, 939, 55-58.
3. Bowman W. C (1980), Prejunctional and postjunctional cholinoreceptors at the neuromuscular junction, Anesth Analg, 59, 935-43.
4. Chevalley C, Spiliopoulos A, Perrot M, et al. (2001), Perioperative medical management and outcome following thymectomy for myasthenia gravis, General anesthesia, 48(5), 446-451.
5. Viby-Mogensen J, Engbaek J, Eriksson L. I, et al. (1996), Good clinical research practice (GCRP) in pharmacodynamic studies of neuromuscular blocking agents, Acta Anaesthesiol Scand, 40, 59-74.
6. Nitahara K, Sugi Y, Higaand K, et al. (2007), Neuromuscular effects of sevoflurane in myasthenia gravis patients, Bristish Journal of Anesthesia 98 (3), 337-41.
7. Heike Knoll, Stephan Ziegeler, Jan- Uwe Schreiberand et al. (2006), Airway injuries after one-lung ventilation: A comparision between double - lumen tube and endobronchial blocker, Anesthesiology, 105, 471-477.
8. Giorgio D. R, Cecilia C, Laura D, et al. (2003), Propofol or sevoflurane anesthesia without muscle relaxants allow the early extubation of myasthenic patients, General anesthesia, 50 (6), 547-552.
9. Orathy Patangi Sanjay, Parvatha Prashanth, Ponnuswamy Karpagamand, et al. (2004), Propofol or sevoflurane anesthesia without muscle relaxants for thymectomy in myasthenia gravis, Indian Journal Thorac Cardiovasc Surg, 20, 83-87.
10. Zhong T, Wang W, Chen Jand, et al. (2009), Sore throat or hoarse voice with bronchial blockers or double-lumen tubes for lung isolation: a randomised, prospective trial, Anaesth Intensive Care, 37, 441-6.
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