Document Detail


Undiagnosed myasthenia gravis unmasked by neuromuscular blockade.
MedLine Citation:
PMID:  11575353     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M F Dunsire; S G Clarke; J J Stedmon
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  86     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-09-28     Completed Date:  2001-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  727-30     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Fremantle Hospital, WA, Australia.
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MeSH Terms
Descriptor/Qualifier:
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:
50700-72-6/Vecuronium Bromide
Comments/Corrections
Comment In:
Br J Anaesth. 2002 Jan;88(1):153-4; author reply 154   [PMID:  11881880 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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