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Anestezija pri bolniku z miastenijo gravis = Anaesthesia in patients with myasthenia gravisMekiš, Dušan ; Kamenik, MirtMiastenija gravis je avtoimunska bolezen motorične ploščice. Zmanjšanje števila funkcionalnih acetilholinskih receptorjev sovpada s težo klinične slike, ki se kaže z naraščajočo mišično utrujenostjo ... in slabljenjem mišične moči. Miastenijo gravis zdravimo tako, da izboljšamo živčno-mišični prenos z antiholinesteraznimi učinkovinami, zaviramo imunski sistem s kortikosteroidi in imunosupresivi ter zmanjšamo število protiteles v krvi s plazmaferezo. Miastenija gravis je pogosto povezana z morfološkimi spremembami priželjca. Odstranitev priželjca zmanjša potreben odmerek antiholinesterazne učinkovine in potrebo po imunosupresivnih zdravilih. V prispevku smo opisali posebnosti anestezije pri bolnikih z miastenijo gravis in prikazali primer vodenja anestezije za odstranitev priželjca skozi prsnico pri bolnici z miastenijo gravis. Pri bolnici smo anestezijo izvedli s kombinacijo visoke prsne epiduralne anestezije z 0,5% bupivacainom in fentanilom ter popolne intravenske anestezije s propofolom in remifentanilom. Naše izkušnje kažejo, da je kombinacija visoke prsne epiduralne anestezije in popolne intravenske splošne anestezije primerna anestezijska tehnika za odstranitev priželjca skozi prsnico. Omogoča stabilno delovanje obtočil med operacijo, varno odstranitev dihalne cevke po koncu operacije in učinkovito lajšanje bolečin po operaciji.Source: Medicinski razgledi : [medicinski pregledni, strokovni in raziskovalni članki]. - ISSN 0025-8121 (Letn. 42, št. 2, 2003, str. 155-163)Type of material - article, component part ; adult, seriousPublish date - 2003Language - slovenianCOBISS.SI-ID - 1322559
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source: Medicinski razgledi : [medicinski pregledni, strokovni in raziskovalni članki]. - ISSN 0025-8121 (Letn. 42, št. 2, 2003, str. 155-163)
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Database name | Field | Year |
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Mekiš, Dušan | 23184 |
Kamenik, Mirt | 14793 |
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