Anestesia ambulatorial para radioterapia em paciente portador de miastenia gravis: relato de caso

摘要

BACKGROUND AND OBJECTIVES: Myasthenia Gravis (MG) is a rare autoimmune disease, characterized by the reduction in the number of nicotinic receptors in the neuromuscular junction, with an incidence of 14/100,000. The objective of this report is to describe the case of a patient with myasthenia gravis who underwent balanced general anesthesia for radiotherapy of a spinocellular carcinoma of the parotid gland as an outpatient. CASE REPORT: Male patient, 87 years old, 87 kg, physical status ASA III, with a prior history of myasthenia gravis; stroke; pacemaker for a third-degree AV block; and hypertension. He was scheduled for seven 20-minutes radiotherapy sessions under general anesthesia. In the radiotherapy room he was monitored with a cardioscope, noninvasive blood pressure, pulse oxymeter, and underwent general anesthesia with propofol and sevoflurane. After the induction, he maintained spontaneous ventilation with a Guedel canula and nasopharyngeal catheter with O2 /sevoflurane for proper fitting of the immobilizing mask. He did not present any complications in the post-anesthetic recovery room. CONCLUSIONS: The choice of anesthetics and strict clinical follow-up allowed an elderly patient, with prior stroke and cardiopathy, to be submitted to balanced general anesthesia for radiotherapy, as an outpatient, with good response.