| Undiagnosed myasthenia gravis unmasked by neuromuscular blockade. | |
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MedLine Citation:
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PMID: 11575353 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Myasthenia gravis is an uncommon autoimmune disease resulting in destruction of the postsynaptic nicotinic receptors at the neuromuscular junction. We describe a 43-yr-old, 95 kg patient who presented for elective laparoscopic cholecystectomy. She was given vecuronium 10 mg to facilitate tracheal intubation. At the end of the procedure the patient could not maintain adequate spontaneous ventilation despite administration of two doses of neostigmine 2.5 mg. Subsequent investigation led to a diagnosis of myasthenia gravis. We discuss the investigation, diagnosis, and subsequent management of such a patient and emphasize that tactile estimation of the train-of-four ratio is not a reliable indicator of adequate recovery of neuromuscular function. |
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Authors:
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M F Dunsire; S G Clarke; J J Stedmon |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: British journal of anaesthesia Volume: 86 ISSN: 0007-0912 ISO Abbreviation: Br J Anaesth Publication Date: 2001 May |
Date Detail:
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Created Date: 2001-09-28 Completed Date: 2001-12-04 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 727-30 Citation Subset: IM |
Affiliation:
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Department of Anaesthesia, Fremantle Hospital, WA, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cholecystectomy, Laparoscopic Female Humans Monitoring, Intraoperative / methods Myasthenia Gravis / complications, diagnosis* Neuromuscular Blockade* Postoperative Complications Respiratory Insufficiency / etiology Vecuronium Bromide |
| Chemical | |
Reg. No./Substance:
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50700-72-6/Vecuronium Bromide |
| Comments/Corrections | |
Comment In:
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Br J Anaesth. 2002 Jan;88(1):153-4; author reply 154
[PMID:
11881880
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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