Biomaterial Database

Anesthesia for transcervical thymectomy in myasthenia gravis. 1976

D S Girnar, and A I Weinreich

This review of anesthetic experience in 100 cases of transcervical thymectomy for myasthenia gravis (MG) at The Mount Sinai Hospital (1970-1974) underlines current trends in the surgical management at Mount Sinai, where transcervical thymectomy is the procedure of choice for all patients with nonthymomatous MG and for selected patients with thymomatous MG. The transthoracic approach is now limited to malignant thymomas and tumors not accessible through the transcervical approach. Formerly, patients coming for thymectomy either already had a preexisting tracheostomy, or an elective tracheostomy was performed at the time of thymectomy. Since 1972, none of these patients has had elective tracheostomy at the time of operation, and only four were performed in the postoperative period, patients being intubated orotracheally at the time of operation. The tube is usually removed within 1 hour after completion of thymectomy. All patients are followed in the intensive care unit for 24 hours or longer, under close supervision of experienced personnel aware of the inherent problems and able to assist ventilation at any stage. This approach has greatly changed the postoperative course of this disease.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009157	Myasthenia Gravis	A disorder of neuromuscular transmission characterized by fatigable weakness of cranial and skeletal muscles with elevated titers of ACETYLCHOLINE RECEPTORS or muscle-specific receptor tyrosine kinase (MuSK) autoantibodies. Clinical manifestations may include ocular muscle weakness (fluctuating, asymmetric, external ophthalmoplegia; diplopia; ptosis; and weakness of eye closure) and extraocular fatigable weakness of facial, bulbar, respiratory, and proximal limb muscles. The disease may remain limited to the ocular muscles (ocular myasthenia). THYMOMA is commonly associated with this condition.	Anti-MuSK Myasthenia Gravis,MuSK MG,MuSK Myasthenia Gravis,Muscle-Specific Receptor Tyrosine Kinase Myasthenia Gravis,Muscle-Specific Tyrosine Kinase Antibody Positive Myasthenia Gravis,Myasthenia Gravis, Generalized,Myasthenia Gravis, Ocular,Anti MuSK Myasthenia Gravis,Generalized Myasthenia Gravis,Muscle Specific Receptor Tyrosine Kinase Myasthenia Gravis,Muscle Specific Tyrosine Kinase Antibody Positive Myasthenia Gravis,Myasthenia Gravis, Anti-MuSK,Myasthenia Gravis, MuSK,Ocular Myasthenia Gravis
D009609	Nitrous Oxide	Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.	Laughing Gas,Nitrogen Protoxide,Gas, Laughing,Oxide, Nitrous
D011175	Positive-Pressure Respiration	A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange.	Positive End-Expiratory Pressure,Positive-Pressure Ventilation,End-Expiratory Pressure, Positive,End-Expiratory Pressures, Positive,Positive End Expiratory Pressure,Positive End-Expiratory Pressures,Positive Pressure Respiration,Positive Pressure Ventilation,Positive-Pressure Respirations,Positive-Pressure Ventilations,Pressure, Positive End-Expiratory,Pressures, Positive End-Expiratory,Respiration, Positive-Pressure,Respirations, Positive-Pressure,Ventilation, Positive-Pressure,Ventilations, Positive-Pressure
D011182	Postoperative Care	The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)	Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D011229	Preanesthetic Medication	Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.	Medication, Preanesthetic,Medications, Preanesthetic,Preanesthetic Medications
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D004737	Enflurane	An extremely stable inhalation anesthetic that allows rapid adjustments of anesthesia depth with little change in pulse or respiratory rate.	Alyrane,Enfran,Enlirane,Ethrane,Etran
D005260	Female		Females