Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Aug 2002
[Use of mivacurium chloride during transsternal thymectomy in myasthenic patient].
Myasthenia gravis is an autoimmune disease characterized by the presence of circulating IgG antibodies, which interact with acetylcholine receptors and interfere with neuromuscular transmission. ⋯ The anesthetic effect of mivacurium was twice as great in myasthenic patients, in whom it behaved like an intermediate-level non-depolarizing muscle relaxant. Mivacurium can reduce prolonged mechanical ventilation in patients who are myasthenic or pharmacologically immunosuppressed and at risk of sepsis arising in the respiratory tract.
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Rev Esp Anestesiol Reanim · Aug 2002
Case Reports[Anesthesia for cesarean section in a patient with von Hippel-Lindau disease].
We report the case of a pregnant 38-year-old woman at full-term who had a history of von Hippel-Lindau disease with neurological symptoms. She had previously undergone surgical removal of cerebellar hemangioblastomas. A cesarean delivery performed under general anesthesia was uneventful and the outcomes were excellent for both mother and fetus. ⋯ As such involvement could not be ruled out, we preferred to avoid the risks related to regional anesthesia. One of the main features of von Hippel-Lindau disease is the presence of central nervous system hemangioblastomas, which are highly vascularized, slow growing tumors that may become enlarged during pregnancy. We describe the implications of the disease for anesthesia.