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Forum Name: Neurology Topics

Question: myasthenia gravis and sedation for bronchoscopy?


 jodie1 - Fri Sep 19, 2008 11:02 am

Hi,
I would like to know what sedatives might be safe to use and which might be dangerous for a patient with myasthenia gravis, e.g is midazolam appropriate or fentaryl or are there safer alternatives? ( Patient has had very severe reaction to Xanax before MG was diagnosed). Also is spraying Lidocain local anaesthetic on the throat and vocal cords safe for someone who has had a lot of throat weakness due to myasthenia gravis?
Thanks Jodie
 John Kenyon, CNA - Thu Dec 18, 2008 10:12 pm

User avatar Hello -

The decision as to what sort of anesthesia to use depends upon the type of surgery, the overall health of the patient, and the status of the patient as regards the disease (MG) at the time of the surgery. For these reasons more than one method may be kept at the ready in case the one of first choice becomes less than ideal. (As you know, I'm sure, MG can run a variable course, but even in remission it's still there, and the stress of impending surgery may exacerbate it in some patients).

The best source of information for this re: the patient in question would be an anesthesiologist, preferably the one who will be attending, but since this is so often a changeable situation (which anesthesiologist will be attending), and since they are all equally knowlegeable (which is why they may be interchangeable) any one should be able to give you an answer. There are far too many variables for me to consider and anesthesiologists are, as a specialty group so very knowlegable, I'd point you in that direction rather than speculate about a given MG patient.

I hope this is at least helpful to you. Best of luck to you (and/or the patient if it is someone else), and please update us.

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