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thymectomy anesthesia

Long Jiang, Jun Liu, Wenlong Shao, Jingpei Li, Jianxing He
Trans-sternal thymectomy has long been accepted as the standard surgical procedure for thymic masses. Recently, minimally invasive methods, such as video-assisted thoracoscopic surgery (VATS) and, even more recently, non-intubated anesthesia, have emerged. These methods provide advantages including reductions in surgical trauma, postoperative associated pain, and in regards to VATS, provide certain cosmetic benefits. Considering these advantages, we herein present a case of subxiphoid uniportal VATS for thymic mass using a glasses-free 3D thoracoscopic display system...
December 2016: Journal of Thoracic Disease
X-Z Liu, C-W Wei, H-Y Wang, Y-H Ge, J Chen, J Wang, Y Zhang
OBJECTIVE: The current study aims to explore the effects of general-epidural anaesthesia (GEA) on the perioperative haemodynamics in patients with myasthenia gravis (MG), as well as their extubation time. METHODS: A total of 42 MG patients (Ossermann I-II b types) receiving elective total thymectomy were randomized into GEA (n = 20) and general anaesthesia alone (GA; n = 22) groups. Changes in their mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia and at the time of intubation, skin incision, sternotomy and extubation...
March 2015: West Indian Medical Journal
Bassam M Shoman, Hany O Ragab, Ammar Mustafa, Rashid Mazhar
With the introduction of new techniques and advances in the thoracic surgery fields, challenges to the anesthesia techniques had became increasingly exponential. One of the great improvements that took place in the thoracic surgical field was the use of the robotically assisted thoracic surgical procedure and minimally invasive endoscopic thoracic surgery. One lung ventilation technique represents the core anesthetic management for the success of those surgical procedures. Even with the use of effective one lung ventilation, the patient hemodynamics and respiratory parameters could be deranged and could not be tolerating the procedure that could compromise the end result of surgery...
2015: Case Reports in Anesthesiology
Eugenio Pompeo, Roberto Sorge, Andrej Akopov, Miguel Congregado, Tomasz Grodzki
BACKGROUND: A survey amongst the European Society of Thoracic Surgeons (ESTS) members has been performed to investigate the currents trends, rates of adoption as well as potential for future expansion of non-intubated thoracic surgery (NITS) performed under spontaneous ventilation. METHODS: A 14-question-based questionnaire has been e-mailed to ESTS members. To facilitate the completion of the questionnaire, questions entailed either quantitative or multiple-choice answers...
March 2015: Annals of Translational Medicine
Yoshihito Fujita, Satoru Moriyama, Satoshi Aoki, Saya Yoshizawa, Maiko Tomita, Taiki Kojima, Yukiko Mori, Naoko Takeuchi, Min-Hye So, Motoki Yano, Kazuya Sobue
Although maintaining anesthesia for myasthenia gravis (MG) with minimal muscle relaxants (MR) is common, the success rate of anesthetic management for MG without MR is not clear. We therefore retrospectively examined the success rate of anesthetic management for MG without MR among 66 consecutive cases of thymectomy for MG performed at our hospital between January 2004 and April 2010, before approval of using sugammadex. A total of 60 patients (90.9 %) were treated without MR (N group). Among the 60 cases, 17 (28...
October 2015: Journal of Anesthesia
Yun Li, Jun Wang
BACKGROUND: Video-assisted thoracoscopic thymectomy was developed more than 10 years ago and has become a widely accepted surgical approach. Most published reports regarding this procedure have focused on the right-sided approach. Since left-sided approach chest surgery is the first choice in cases of right pleural adhesion, large left thymus tumors, and tumors in close contact with the great vessels of the left pericardium, we performed thoracoscopic thymectomy using the left-sided approach in 52 cases and summarize herein its technical feasibility, indications, and operative steps...
2014: World Journal of Surgical Oncology
Valluvan Rangasamy, Kaushal Kumar, Amit Rai, Dalim Kumar Baidya
Literature on anesthetic management of juvenile myasthenia gravis (JMG) for thymectomy is limited. Recently, use of inhalational agents and total intravenous anesthesia with propofol and remifentanyl has been reported. All these techniques individually or in combination have been tried to avoid the use of muscle relaxant. We report successful use of sevoflurane as sole anesthetic agent for intubation and in combination with thoracic epidural anesthesia for intraoperative anesthetic management in a 5-year-old child with JMG...
April 2014: Journal of Anaesthesiology, Clinical Pharmacology
Naomi Ono, Nobuyasu Komasawa, Shoko Nakano, Ayumu Kuwamura, Shinichi Tatsumi, Toshiaki Minami
Successful tracheal intubation with a double-lumen tube was achieved using Pentax-AWS Airwayscope (AWS) with an infant-size Intlock in a patient with restricted mouth opening and head tilting. A 78-year-old woman with rheumatoid arthritis was scheduled for extended thymectomy under general anesthesia, with anticipated difficult airway. Sufficient mask ventilation with the jaw-thrust maneuver was achieved. The laryngoscopic view was defined as grade III (Cormack & Lehane's classification)with Macintosh laryngoscope...
April 2014: Masui. the Japanese Journal of Anesthesiology
Takuya Oguri, Kazuki Hisatomi, Shoji Kawashima, Yoshino Ueki, Naoko Tachibana, Noriyuki Matsukawa
No abstract text is available yet for this article.
January 2014: Sleep Medicine
Erisa Nakamori, Keiichi Nitahara, Yasuyuki Sugi, Kiyoshi Katori, Akiko Matsuzaki, Kazuo Higa
We report a patient with myasthenia gravis whose rocuronium induced neuromuscular block was reversed with sugammadex. A 26-year-old man, 175 cm and 76 kg, with myasthenia gravis, was scheduled for extended thymectomy under general anesthesia. An epidural catheter was inserted at the T5-6 interspace before induction of general anesthesia. Anesthesia was induced with propofol and remifentanil. Rocuronium was given in divided doses to obtain > 95% neuromuscular block to intubate the trachea. The ED50 and ED95 of rocuronium for this patient were 0...
August 2013: Masui. the Japanese Journal of Anesthesiology
T Morita, H Tsukagoshi, D Kurosaki, T Sugaya, D Yoshikawa, H Shimada
The current study evaluated the neuromuscular responses following administration of sevoflurane in 14 patients with myasthenia gravis (MG) (I-IIb in Osserman's classification) scheduled for thymectomy and in 11 control patients (ASA I-II) who underwent elective surgery. The electromyographic (EMG) response of the abductor digiti minimi was measured following train-of-four (TOF) stimulation of the ulnar nerve every 20 s. After induction of anesthesia with a combination of 3-4 mg·kg(-1) thiopental and 1-2 μg·kg(-1) fentanyl with 66% N2O and oxygen, an inspired concentration of 4% sevoflurane was administered via a face mask for 7 min...
September 1996: Journal of Anesthesia
Rita Sonzogni, Lorenzo Novellino, Alberto Benigni, Ilaria Busi, Magda Khotcholava, Angelica Spotti, Valter Sonzogni
Myasthenia gravis (MG) is an autoimmune disease marked by weakness of voluntary musculature. Medical and surgical therapy of adult myasthenia is well documented. There is little pediatric surgical evidence, only a few case reports being available. The aim of this paper is to verify whether the surgical and anesthesiological techniques can warrant an early and safe discharge from the operating room. The secondary aim is to assess the presence of perioperative indicators that can eventually be used as predictors of postoperative care...
February 5, 2013: Pediatric Reports
Takashi Etoh, Hidenori Kouso, Keita Sonoda
BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease. The MG patients undergoing extended thymectomy under general anesthesia are at risk for postoperative complications, such as respiratory insufficiency and crisis (cholinergic and myasthenic). We evaluated the preoperative predictive factors, which are important for postoperative respiratory control. METHODS: Four patients undergoing extended thymectomy under general anesthesia in our hospital within the last two years (2008-2010) were studied...
October 2012: Masui. the Japanese Journal of Anesthesiology
Nahum Nesher, Dmitry Pevni, Galit Aviram, Amir Kramer, Rephael Mohr, Gideon Uretzky, Yanai Ben-Gal, Yosef Paz
OBJECTIVE: Thymectomy for thymoma has traditionally been performed through midsternotomy that provides excellent exposure for a complete and safe resection. Minimally invasive alternatives have not been extensively evaluated for this disease process because data regarding the long-term oncologic effectiveness of these techniques remain to be established. Furthermore, video-assisted surgery as a unilateral approach may compromise the extension of the resection and could cause irreversible damage to the phrenic nerve of the opposite side...
July 2012: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Akiko Takeda, Makoto Kawamura, Izumi Hamaya, Hanae Kitamura, Rika Muto, Hiroyuki Mitono
Neuromuscular blocking drugs (NMBDs) can predispose patients with myasthenia gravis to postoperative paralysis and respiratory complications. We had a 12-year-old female patient undergoing thoracoscopic thymectomy. She had suffered from MGFA class IIa (mild systemic) myasthenia gravis for 4 months. Anesthesia was induced with 3 mg x kg(-1) of thiopental and 0.2 mg x kg(-1) of rocuronium, which was given incrementally to achieve 100% blockade. Anesthesia was maintained with oxygen, air, 2% sevoflurane and 0...
August 2012: Masui. the Japanese Journal of Anesthesiology
Eugenio Pompeo
Awake thoracic surgery is performed by regional anesthesia techniques in spontaneously breathing, fully conscious patients to avoid side-effects of general anesthesia, fasten recovery, and reduce morbidity, particularly in high-risk patients. Results of ongoing experience are promising, and this novel surgical approach has been successfully applied to several thoracoscopic procedures, including management of pleural effusion, wedge resections, lung volume reduction surgery, bullectomy, and thymectomy. In this article, the historical background, main pathophysiology features of the surgical pneumothorax, and the various regional anesthesia techniques as well as reported results are reviewed and critically discussed...
2012: Seminars in Thoracic and Cardiovascular Surgery
Kotaro Mizuno, Tsutomu Tatematsu, Risa Oda, Takeshi Yamada
A 40-year-old woman with generalized myasthenia gravis was scheduled for extended thymectomy. The patient under general anesthesia with double-lumen intubation was placed in the supine position. A sealed 5 mm trocar and 2 sealed 12 mm trocars were inserted through the 3rd, 4th and 5th intercostal space at the both side of the anterior axillary line. Under carbon dioxide insufflations by positive pressure of 7 mmHg, thymus and fat tissue was resected completely. An operation time was 162 minutes, and blood losses during operation were 5 ml...
August 2012: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Yoshihisa Fujino, Kengo Maeda, Nobuhiro Ogawa, Takuya Fujita, Chiho Matsuyama, Takao Saotome, Yoshitomo Ozaki, Masatsugu Ohuchi, Shuhei Inoue
Combined epidural and general anesthesia has become a standard anesthetic method for thymectomy. We employed levobupivacaine for epidural anesthesia combined with general anesthesia using remifentanil and sevoflurane for thymectomy with thoracoscopy for generalized type of myasthenia gravis. After decreasing the high level of antibodies to acethylcholine receptor by plasmapheresis, we could perform a stable and successful anesthetic management without the use of any muscle relaxants for the thymectomy. And a myasthenic crisis did not occur after the procedure...
May 2012: Masui. the Japanese Journal of Anesthesiology
S Renaud, N Santelmo, M Renaud, M-C Fleury, J De Seze, C Tranchant, G Massard
BACKGROUND: The role of thymectomy in myasthenia gravis remains controversial. The remission rate 5years after surgery varies from 13 to 51% in the literature. Sternotomy is the standard technique, though unacceptable by patients because of significant esthetic sequelae. Our objective was to demonstrate that the robot-assisted technique using the Da Vinci Surgical Robot II is at least as efficient and leaves fewer scars than the standard surgical technique. METHODS: We retrospectively reviewed the data of 31 consecutive patients suffering from myasthenia gravis who underwent surgery in our center from January 1998 to March 2010...
January 2013: Revue Neurologique
Takahiro Tadokoro, Soichiro Yamashita, Maiko Ishigaki, Shinji Takahashi, Makoto Tanaka
Stiff-person syndrome is an uncommon disease characterized by muscular rigidity and painful spasms in the axial and limb muscles. We report a 58-year-old woman with stiff-person syndrome undergoing thymectomy under general anesthesia. Before surgery, her medications were 25 mg of diazepam, 2 mg of clonazepam, and 15 mg of gabapentin per day. After epidural catheterization for the postoperative analgesia, general anesthesia was induced and maintained with continuous remifentanil infusion and propofol with target controlled infusion...
February 2012: Masui. the Japanese Journal of Anesthesiology
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