Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia Gravis

We describe the anesthetic management of a patient with severe myasthenia gravis and tracheal stenosis; the patient was scheduled for direct laryngoscopy and dilatation. The combination of myasthenia gravis and tracheal obstruction presents several difficulties for anesthetic management. The airway...

Full description

Saved in:
Bibliographic Details
Main Authors: Hesham A. Elsharkawy, Ursula Galway
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Anesthesiology
Online Access:http://dx.doi.org/10.1155/2012/217561
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849414583598448640
author Hesham A. Elsharkawy
Ursula Galway
author_facet Hesham A. Elsharkawy
Ursula Galway
author_sort Hesham A. Elsharkawy
collection DOAJ
description We describe the anesthetic management of a patient with severe myasthenia gravis and tracheal stenosis; the patient was scheduled for direct laryngoscopy and dilatation. The combination of myasthenia gravis and tracheal obstruction presents several difficulties for anesthetic management. The airway is shared; therefore, any complications are also shared by the anesthesiologist and bronchoscopists. The potential for respiratory compromise in patients undergoing the two procedures requires that anesthesiologists be familiar with the underlying disease state, as well as the interaction of anesthetic and nonanesthetic drugs in a case involving myasthenia gravis. We reviewed the literature and report our experience in this case. There is no strong evidence for choosing one approach to general anesthesia over another for bronchoscopy. Careful preoperative planning and experience in airway management and jet ventilation are crucial to prevent an adverse outcome and obtain favorable results.
format Article
id doaj-art-6c0d39a5beb54f648a68037d681a4eef
institution Kabale University
issn 2090-6382
2090-6390
language English
publishDate 2012-01-01
publisher Wiley
record_format Article
series Case Reports in Anesthesiology
spelling doaj-art-6c0d39a5beb54f648a68037d681a4eef2025-08-20T03:33:46ZengWileyCase Reports in Anesthesiology2090-63822090-63902012-01-01201210.1155/2012/217561217561Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia GravisHesham A. Elsharkawy0Ursula Galway1Department of General Anesthesiology and Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USADepartment of General Anesthesiology and Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USAWe describe the anesthetic management of a patient with severe myasthenia gravis and tracheal stenosis; the patient was scheduled for direct laryngoscopy and dilatation. The combination of myasthenia gravis and tracheal obstruction presents several difficulties for anesthetic management. The airway is shared; therefore, any complications are also shared by the anesthesiologist and bronchoscopists. The potential for respiratory compromise in patients undergoing the two procedures requires that anesthesiologists be familiar with the underlying disease state, as well as the interaction of anesthetic and nonanesthetic drugs in a case involving myasthenia gravis. We reviewed the literature and report our experience in this case. There is no strong evidence for choosing one approach to general anesthesia over another for bronchoscopy. Careful preoperative planning and experience in airway management and jet ventilation are crucial to prevent an adverse outcome and obtain favorable results.http://dx.doi.org/10.1155/2012/217561
spellingShingle Hesham A. Elsharkawy
Ursula Galway
Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia Gravis
Case Reports in Anesthesiology
title Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia Gravis
title_full Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia Gravis
title_fullStr Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia Gravis
title_full_unstemmed Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia Gravis
title_short Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia Gravis
title_sort anesthetic management of direct laryngoscopy and dilatation of subglottic stenosis in a patient with severe myasthenia gravis
url http://dx.doi.org/10.1155/2012/217561
work_keys_str_mv AT heshamaelsharkawy anestheticmanagementofdirectlaryngoscopyanddilatationofsubglotticstenosisinapatientwithseveremyastheniagravis
AT ursulagalway anestheticmanagementofdirectlaryngoscopyanddilatationofsubglotticstenosisinapatientwithseveremyastheniagravis