E-ISSN 2231-170X | ISSN 2231-1696
 

Case Report
Online Published: 12 Jul 2025
 


Anesthetic management of a patient with myasthenia gravis posted for thymectomy using general anesthesia with regional anesthesia without muscle relaxant technique: A case report

Madanmohan Shiraboina, G. Nagaraj Goud, Syed Ibrahim Zubair, Varalakshmi Priya, Harshitha Porika, H. L. Baby Rani.


Abstract
Myasthenia gravis is an autoimmune disease that results from antibodies against post-synaptic nicotinic acetylcholine (Ach) receptors at the neuromuscular junction (NMJ). Myasthenia gravis (MG) is a long-term disease that leads to varying degrees of skeletal muscle weakness. Ocular, facial, and pharyngeal muscles are most commonly affected. Those affected often have thymic hyperplasia or develop a thymoma. Diagnosis is by blood tests for specific antibodies, edrophonium test or nerve conduction studies. Acetylcholinesterase inhibitors are the first line drugs of treatment. Sometimes immunosuppressants like prednisone or azathioprine may also be used. Plasmapheresis and high-dose intravenous immunoglobulin may be used during MG crisis. Thymectomy may induce remission or reduce the antibodies against Ach receptors. If the respiratory muscles are involved significantly, mechanical ventilation may be required. Anesthesia for myasthenia gravis is challenging for anesthesiologists because of the interaction of anticholinesterase drugs with both depolarizing and non-depolarizing muscle relaxants. Several reports have been published on anesthetic management of myasthenic patients undergoing transsternal thymectomy.

Key words: Acetylcholinesterase inhibitors, Autoimmune disease, Myasthenia gravis, Thymectomy


 
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How to Cite this Article
Pubmed Style

Shiraboina M, Goud GN, Zubair SI, Priya V, Porika H, Rani HLB. Anesthetic management of a patient with myasthenia gravis posted for thymectomy using general anesthesia with regional anesthesia without muscle relaxant technique: A case report. J Med Allied Sci. 2025; 15(1): 103-105. doi:10.5455/jmas.220459


Web Style

Shiraboina M, Goud GN, Zubair SI, Priya V, Porika H, Rani HLB. Anesthetic management of a patient with myasthenia gravis posted for thymectomy using general anesthesia with regional anesthesia without muscle relaxant technique: A case report. https://jmas.in/?mno=220459 [Access: July 12, 2025]. doi:10.5455/jmas.220459


AMA (American Medical Association) Style

Shiraboina M, Goud GN, Zubair SI, Priya V, Porika H, Rani HLB. Anesthetic management of a patient with myasthenia gravis posted for thymectomy using general anesthesia with regional anesthesia without muscle relaxant technique: A case report. J Med Allied Sci. 2025; 15(1): 103-105. doi:10.5455/jmas.220459



Vancouver/ICMJE Style

Shiraboina M, Goud GN, Zubair SI, Priya V, Porika H, Rani HLB. Anesthetic management of a patient with myasthenia gravis posted for thymectomy using general anesthesia with regional anesthesia without muscle relaxant technique: A case report. J Med Allied Sci. (2025), [cited July 12, 2025]; 15(1): 103-105. doi:10.5455/jmas.220459



Harvard Style

Shiraboina, M., Goud, . G. N., Zubair, . S. I., Priya, . V., Porika, . H. & Rani, . H. L. B. (2025) Anesthetic management of a patient with myasthenia gravis posted for thymectomy using general anesthesia with regional anesthesia without muscle relaxant technique: A case report. J Med Allied Sci, 15 (1), 103-105. doi:10.5455/jmas.220459



Turabian Style

Shiraboina, Madanmohan, G. Nagaraj Goud, Syed Ibrahim Zubair, Varalakshmi Priya, Harshitha Porika, and H. L. Baby Rani. 2025. Anesthetic management of a patient with myasthenia gravis posted for thymectomy using general anesthesia with regional anesthesia without muscle relaxant technique: A case report. Journal of Medical and Allied Sciences, 15 (1), 103-105. doi:10.5455/jmas.220459



Chicago Style

Shiraboina, Madanmohan, G. Nagaraj Goud, Syed Ibrahim Zubair, Varalakshmi Priya, Harshitha Porika, and H. L. Baby Rani. "Anesthetic management of a patient with myasthenia gravis posted for thymectomy using general anesthesia with regional anesthesia without muscle relaxant technique: A case report." Journal of Medical and Allied Sciences 15 (2025), 103-105. doi:10.5455/jmas.220459



MLA (The Modern Language Association) Style

Shiraboina, Madanmohan, G. Nagaraj Goud, Syed Ibrahim Zubair, Varalakshmi Priya, Harshitha Porika, and H. L. Baby Rani. "Anesthetic management of a patient with myasthenia gravis posted for thymectomy using general anesthesia with regional anesthesia without muscle relaxant technique: A case report." Journal of Medical and Allied Sciences 15.1 (2025), 103-105. Print. doi:10.5455/jmas.220459



APA (American Psychological Association) Style

Shiraboina, M., Goud, . G. N., Zubair, . S. I., Priya, . V., Porika, . H. & Rani, . H. L. B. (2025) Anesthetic management of a patient with myasthenia gravis posted for thymectomy using general anesthesia with regional anesthesia without muscle relaxant technique: A case report. Journal of Medical and Allied Sciences, 15 (1), 103-105. doi:10.5455/jmas.220459