J Dent Anesth Pain Med.  2019 Feb;19(1):67-72. 10.17245/jdapm.2019.19.1.67.

Anesthetic considerations for a patient with myasthenia gravis undergoing deep sedation in an outpatient oral surgery setting

• Prabhu SS
• Khan SA
• Doudnikoff AL
• Reebye UN

• KMID: 2439037
• DOI: http://doi.org/10.17245/jdapm.2019.19.1.67

Abstract

Myasthenia gravis (MG) is a neuromuscular autoimmune disorder which clinically presents as muscular weakness and fatigue due to autoantibody formation against acetylcholine receptors (AChR), leading to their subsequent destruction. Due to the neuromuscular implications of MG, certain considerations must be taken into account when providing anesthesia to MG patients. In the following case report, we have outlined procedural considerations for the anesthetic management of a patient with MG undergoing deep sedation for an elective oral surgery in an outpatient setting, as well as a discussion of relevant literature.

Keyword

Anesthesia; Myasthenia Gravis; Oral Surgery

MeSH Terms

Anesthesia
Deep Sedation*
Fatigue
Humans
Muscle Weakness
Myasthenia Gravis*
Outpatients*
Receptors, Cholinergic
Surgery, Oral*
Receptors, Cholinergic

Figure

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  Fig. 1 Pathophysiologic pathways of MG: (1) AChR autoantibody destruction, (2) ACh binding site blockage, (3) Complement-mediated destruction of AChR and motor end plate.

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