Anesthetic management of a patient with Myasthenia Gravis for abdominal surgery

This case report focuses on the anesthetic management of a patient with Myasthenia Gravis who underwent left-sided colectomy, due to the presence of a tumor on the left colic (splenic) flexure. Myasthenia gravis is a chronic autoimmune neuromuscular disease which is characterized by different degrees of weakness of skeletal muscles. The anesthetic management and treatment of every patient with myasthenia gravis should be performed carefully, due to the fact that many perioperative complications may occur. In our case anesthetic technique included the combination of general anesthesia, with the use of neuromuscular agent and thoracic epidural blockade with the use of a catheter, which permitted intermittent boluses doses and continuous infusion of local anesthetics and opioids. Neuromuscular blockade was reversed with the use of sugammadex. Patient's perioperative management was effective and uneventful.