Sevoflurane as a sole anaesthetic for thymectomy in myasthenia gravis

Myasthenia gravis is a challenging situation for anaesthesiologists due to its neuromuscular involvement. The main concerns are respiratory muscle wea kness and side effects due to a heavy dose of anticholinesterases. This lim its the use of sedatives, hypnotics and muscle relaxants. Inhalational anae sthetics are best suited. We describe our experience with sevoflurane as a sole anaesthetic in a child having juvenile-type myasthenia gravis with thy moma, who underwent thymectomy by midsternal incision. Very smooth and shor t duration of induction (35 s) and easy intubation within 60 s without use of muscle relaxant were the remarkable features. Sevoflurane in oxygen and nitrous oxide (MAC=0.5-0.7) was used for maintenance of anaesthesia. Recove ry was smooth and fast with no residual respiratory insufficiency. Hence we found sevoflurane to be a highly suitable agent for thymectomy in mystheni a gravis.