2003, Número 3
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An Med Asoc Med Hosp ABC 2003; 48 (3)
Manejo anestésico del paciente con miastenia gravis
Reyes ERE, Olivares MH, Espíritu MS
Idioma: Español
Referencias bibliográficas: 47
Paginas: 156-161
Archivo PDF: 61.17 Kb.
RESUMEN
La miastenia gravis tiene una patología caracterizada por alteraciones de la placa neuromuscular, las cuales se deben a la producción de anticuerpos dirigidos contra los receptores nicotínicos de acetilcolina de la membrana posináptica de la placa neuromuscular. Clínicamente, esto se traduce en debilidad muscular. En este artículo, se describen los puntos clave del manejo perioperatorio que incluyen: la valoración preanestésica, la relación clasificación/morbilidad y mortalidad, el manejo anestésico y posoperatorio.
REFERENCIAS (EN ESTE ARTÍCULO)
Willis T. De anima brutorum quae hominis vitalis ac sensitiva est, exercitationes duae. Oxford, England: Londini, Typis EF, impensis Ric Davis, 1672.
Grob D, Brunner NG, Namba T. The natural course of myasthenia gravis and effect of therapeutic measures. Ann NY Acad Sci 1981; 377: 652-669.
Noonan CW, Kathman SJ, White MC. Prevalence estimates for MS in the United States and evidence of an increasing trend for women. Neurology 2002; 58 (1): 136-138.
Lindstrom JM. Acetylcholine receptors and myasthenia. Muscle Nerve. 2000; 23 (4): 453-477.
Pestronk A, Drachman DB, Self SG. Measurement of junctional acetylcholine receptors in myasthenia gravis: clinical correlates. Muscle Nerve 1985; 8 (3): 245-251.
O´Connell Frank: Myasthenia Gravis. En: Atlee JL. Complications in anesthesia. Philadelphia, PA: WB Saunders, 1999: 490-493.
Drachman DB. Myasthenia gravis. New Engl J Med 1994; 330 (25): 1797-810.
Grob D, Arsura EL, Brunner NG, Namba T. The course of myasthenia gravis and therapies affecting outcome. Ann NY Acad Sci 1987; 505: 472-99.
Robert M. Pascuzzi. Medications and Myasthenia Gravis; A Reference for Health Care Professionals. En: Myasthenia Gravis Foundation of America. www.myasthenia.org. Oct. 2000.
Ossermann KE, Genkins G. Studies on myasthenia gravis: review of a twenty-years experience in over 1200 patients. Mount Sinai J Med 1971; 38: 497-537.
Baraka A. Anesthesia and critical care of thymectomy for myasthenia gravis. En: Krischner PA (ed). Chest Surg Clin North Am 2001; 11 (2): 337-361.
Jaretzki A 3rd, Barohn RJ, Ernstoff RM. Kaminski HJ, Keesey JC et al. Myasthenia gravis: Recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America. Neurology 2000; 55 (1): 16-23.
Vincent A, Palace J, Hilton-Jones D. Myasthenia gravis. Lancet 2001; 357 (9274): 2122-2128.
Vincent A. Newsom-Davis J. Acetylcholine receptor antibody as a diagnostic test for myasthenia gravis: results in 153 validated cases and 2967 diagnostic assays. J Neurol Neurosurg Psychiat 1985; 48 (12): 1246-1252.
Small S, Hassan HA, Lennon VA, Brown RH, Carr DB, De Armendi A. Anesthesia for an unsuspected Lambert-Eaton Myasthenic Syndrome with Autoantibodies and occult small cell lung carcinoma. Anesthesiology 1992; 76: 142-145.
Poulas K, Tsibri E, Kokla A, Papanastasiou D, Tsouloufis T et al. Epidemiology of seropositive myasthenia gravis in Greece. J Neurol Neurosurg Psychiat 2001; 71 (3): 352-356.
Baraka A, Taha S, Yazbeck V. Vecuronium block in the myasthenic patient. Influence of anticholinesterase therapy. Anaesthesia 1993; 48: 588-590.
Abel M, Eisenkraft JN, Anaesthesic Implications of Myasthenia Gravis. Mount Sinai J Med 2002; 69 (1-2).
Parr SM, Robinson BJ, Rees D, Galletly DC. Interaction between betamethasone and vecuronium. Br J Anaest 1991; 67 (4): 447-451.
Howard JF. The treatment of myasthenia gravis with plasma exchange. Semin Neurol 1982; 2: 273-288.
Leventhal SR, Orkin FK, Hirsh RA. Prediction of the need for postoperative mechanical ventilation in myasthenia gravis Anesthesiology 1980; 53 (1): 26-30.
Eisenkraft JB, Papatestas AE, Kahn CH, Mora CT, Fagerstrom R, Genkins G. Predicting the need for postoperative mechanical ventilation in myasthenia gravis. Anesthesiology 1986; 65 (1): 79-82.
Saito Y, Sakura S, Takatori T, Kosaka Y. Epidural anesthesia in a patient with myasthenia gravis. Acta Anaest Scand 1993; 37 (5): 513-515.
Baraka A. Anaesthesia and myasthenia gravis. Canad J Anest 1992; 39: 476-486.
Abel M, Eissenkraft JB, Patel N. Response to suxamethonium in a myasthenic patient in remission. Anaesthesia 1991; 46: 30.
Vanlinthout LEH, Robertson EN, Booij KHDJ. Response to suxamethonium during propofol-fentanyl-N2O/O2 anaesthesia in a patient with active myasthenia gravis reciving long term anticholinesterase therapy. Anaesthesia 1994; 49: 509.
Eisenkraft JB, Book WJ, Mann SM. Resistance to succinylcholine in myasthenia gravis: A dose-response study. Anesthesiology 1988; 69: 760-763.
Nilsson E, Meretoja OA. Vecuronium dose-response and maintenance requirements in patients with myasthenia gravis. Anesthesiology 1990; 73: 28-32.
Eisenkraft JB, Book WJ, Papatestas AE. Sensitivity to vecuronium in myasthenia gravis: A dose response study. Canad J Anaest 1990; 37: 301-306.
Bell CF, Florence AM, Hunter JM, Jones RS, Utting JE. Atracurium in the myasthenic patient. Anaesthesia 1984; 39 (10): 961-968.
Smith CE, Donati F, Bevin DR. Cumulative dose-response curves for atracurium in patients with myasthenia gravis. Canad J Anaest 1989; 36: 402-406.
Paterson IG, Hood JR, Russell SH, Weston MD, Hirsch NP. Mivacurium in the myasthenic patient. Br J Anaest 1994; 73 (4): 494-498.
Baraka A, Siddik S, Kawkabani N. Cisatracurium in a myasthenic patient undergoing thymectomy. Canad J Anaest 1999; 46 (8): 779-782.
Itoh H, Shibata K, Nitta S. Difference in sentivity to vecuronium between patients with ocular and generalized myasthenia gravis. Br J Anaest 2001; 87 (6): 885-889.
Itoh H, Shibata K, Nitta S. Sensitivity to vecuronium in seropositive and seronegative patients with myasthenia gravis. Anesthesia & Analgesia 2002; 95 (1): 109-113.
Eisenkraft JB, Papatestas AE, Sivak M. Neuromuscular effects of halogenated agents in patients with myasthenia gravis. Anesthesiology 1984. 61 (3A): A307.
Baraka AS, Taha SK, Kawkabani NI. Neuromuscular interaction of sevoflurane-cisatracurium in a myasthenic patient. Canad J Anest 2000; 47 (6): 562-565.
Wright PM, Hart P, Lau M, Brown R, Sharma ML et al. The magnitude and time course of vecuronium potentiation by desflurane versus isoflurane. Anesthesiology 1995; 82 (2): 404-411.
Kiran U., Choudhury M., Saxena N., Sevoflurane as a sole anaesthesic agent for thymectomy in myasthenia gravis. Acta Anaest Scand 2000; 44: 351-353.
Itoh H, Shibata K. Comparison between sevoflurane and propofol neuromuscular effects in a patient with myasthenia gravis: effective doses of vecuronium. Anesthesiology 2001; 95 (3): 803-805.
Hübler M, Litz RJ, Albrecht DM. Combination of balanced and regional anaesthesia for minimally invasive surgery in a patient with myasthenia gravis. Eur J Anaest 2000; 17 (5): 325-328.
Itoh H, Shibata K, Yoshida M, Yamamoto K. Neuromuscular monitoring at the orbicularis oculi may overestimate the blockade in myasthenic patients. Anesthesiology 2000; 93 (5): 1194-1197.
Newman P. Myasthenia Gravis and Eaton-Lambert syndrome. In: Goldstone JC, Pollard BJ. Clinical anestesia. Nueva York: Churchill Livingstone, 1996; 62-63.
Eisenkraft JB, Neustein SM, Cohen E. Myasthenia gravis. In: Barash PG, Cullen BF, Stoelting RK: Clinical anesthesia. Philadelphia: JB Lippincott, 1989; 977-978.
Dunsire MF. Clarke SG. Stedmon JJ. Undiagnosed myasthenia gravis unmasked by neuromuscular blockade. Br J Anest 2001; 86 (5): 727-730.
Adcock DK. Miastenia grave y síndrome miasténico. En: Bready LL, Smith RB. Decisiones en anestesia. Barcelona: Doyma, 1988; 214-215.
Christensen PB, Jensen TS, Tsiropoulos I, Sorensen T, Kjaer M et al. Mortality and survival in myasthenia gravis: a Danish population based study. J Neurol Neurosurg Psychiat 1998; 64 (1): 78-83.