Article ; Online: Propofol TCI or sevoflurane anesthesia without muscle relaxant for thoracoscopic thymectomy in myasthenia gravis patients: a prospective, observational study.
2023 Volume 23, Issue 1, Page(s) 349
Abstract: Background: Myasthenia gravis (MG) patients interact unpredictably with anesthetic agents, including neuromuscular blocking agents. Here, we investigate the effectiveness of general anesthesia without muscle relaxants using either propofol via target- ... ...
Abstract | Background: Myasthenia gravis (MG) patients interact unpredictably with anesthetic agents, including neuromuscular blocking agents. Here, we investigate the effectiveness of general anesthesia without muscle relaxants using either propofol via target-controlled infusion systems (TCI) or sevoflurane in MG patients undergoing thoracoscopic thymectomy. Methods: This prospective, open-label, observational study was conducted in a university hospital. We included 90 myasthenic patients undergoing thoracoscopic thymectomy with general anesthesia. Patients received induction and maintenance anesthesia with propofol TCI (group P, n = 45) or induction with propofol 2-3 mg.kg Results: All patients achieved good intubation conditions. Hemodynamic instability was more frequent in group S than in group P, mostly in the induction stage, and was controllable. The reduction in the intraoperative train-of-four ratio from baseline at 30 min, 60 min, and 90 min in group S was 10.3%, 14.2%, and 14.3%, respectively, significantly higher than that in group P (6.8%, 7.2%, and 8.4%, respectively), which completely recovered at the end of the surgery. All patients were extubated in the operating room without complications. No other significant differences between the groups were observed. Conclusions: Anesthesia with propofol TCI or sevoflurane without muscle relaxants in MG patients offered safe and effective conditions for thoracoscopic thymectomy. Sevoflurane achieved higher levels of intraoperative muscular relaxation than propofol TCI. Postoperative neuromuscular function was not affected by these anesthetics. |
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MeSH term(s) | Humans ; Propofol/pharmacology ; Sevoflurane ; Thymectomy/methods ; Prospective Studies ; Myasthenia Gravis/surgery ; Anesthesia, General ; Muscles ; Anesthetics, Intravenous ; Methyl Ethers |
Chemical Substances | Propofol (YI7VU623SF) ; Sevoflurane (38LVP0K73A) ; Anesthetics, Intravenous ; Methyl Ethers |
Language | English |
Publishing date | 2023-10-21 |
Publishing country | England |
Document type | Observational Study ; Journal Article |
ZDB-ID | 2091252-3 |
ISSN | 1471-2253 ; 1471-2253 |
ISSN (online) | 1471-2253 |
ISSN | 1471-2253 |
DOI | 10.1186/s12871-023-02296-6 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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