Anesthetic considerations for a patient with myasthenia gravis undergoing deep sedation in an outpatient oral surgery setting

Prabhu, Shamit S.; Khan, Saad; Doudnikoff, Alexander L.; Reebye, Uday N.

doi:10.17245/jdapm.2019.19.1.67

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…6 Nitrous oxide sedation and general anesthesia are safe considering the importance of airway patency. 16 17 In our patient, general anesthesia was chosen given the behavioral difficulties, the comprehensive dental treatment needed, and the primary physician's recommendation because the patient was considered high risk and hospital admission was needed.…”

Section: Discussionmentioning

confidence: 99%

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The Dental Management of Pediatric Patient Diagnosed with Myasthenia Gravis: A Case Report

et al. 2022

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Myasthenia gravis (MG) is a rare autoimmune neurological disorder characterized by muscle weakness and can vary in severity from the mild form that affects the ocular muscles only to the generalized form that affects the other muscle groups. The prevalence of MG is 150 to 200 per million population over the past 50 years, and approximately 10% of these cases are pediatric patients where the disease onset starts before the age of 18 years. The etiology of MG is due to the blockage of neuromuscular transmission by circulating autoantibodies targeting mainly the nicotinic acetylcholine receptor (AChR) and associated proteins in the postsynaptic membrane of skeletal muscles. In MG patients, dental treatment is challenging due to the nature of the condition and its complexity. Moreover, dentists treating MG patients should acquire knowledge about the disease background and the special considerations that need to be taken. In this case report, our aim was to raise awareness about MG among dentists and discuss the dental management of the patients who have this disease and the precautions that should be taken. This case report presents a pediatric MG patient with poor oral hygiene, multiple decayed teeth, dental fluorosis, tongue thrust oral habit that led to anterior open-bite and uncomplicated crown fracture of the upper permanent central incisors. The decision was made to treat the patient under general anesthesia because of the medical condition and the extent of the dental treatment. In the process of preparing the patient for surgery, the patient was cleared from the treating physicians and was admitted under neurology care as per the primary physician. On the day of surgery, the patient received full-mouth dental rehabilitation under general anesthesia, including pulp therapy, crowns, restorations, and extractions. Furthermore, she was seen regularly in recall visits every 3 months.

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Section: Discussionmentioning

confidence: 99%

“…14; class-I composite restorations for teeth nos. 16 Follow-up appointments were scheduled at 2 weeks, 6 weeks, 3 months, and 6 months. The 6-week visit was to evaluate the traumatized upper permanent central incisors and to take periapical radiographs as recommended by the American Academy of Pediatric Dentistry guidelines.…”

Section: Case Reportmentioning

confidence: 99%

The Dental Management of Pediatric Patient Diagnosed with Myasthenia Gravis: A Case Report

et al. 2022

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“…(23). When there is a risk of respiratory failure, especially during surgeries, they must be performed in an environment where artificial ventilation is available (43,44,45). Despite the huge risk of a fatal outcome, prognoses, in recent years, have significantly improved as mortality rates have dropped to 4.5% (46).…”

Section: Other Drugs That Are Contraindicated In Myasthenia Gravismentioning

confidence: 99%

Preoperative management of patients with myasthenia gravis: a review article

Dzhongova,

Edrev

2023

Scripta Scientifica Medicinae Dentalis

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INTRODUCTION: Myasthenia gravis (MG) is an autoimmune neurological disorder characterized by defective transmission at the neuromuscular junction. This neuromuscular disease marked by repetitive intermittent skeletal muscle weakness and fatigue Clinical symptoms are manifested in varying degrees depending on the age of diagnosis and antibodies to acetylcholine receptors. Facial and oropharyngeal muscles are among the most affected by this disease, thus presenting a lot of difficulties when dental treatment is performed. Since the disease is known to specifically affect the masticatory, facial and oropharyngeal muscles, dental treatment proves very challenging for dentists and patients alike. In order to choose the optimal and less invasive treatment approach and avoid inherent complications, dentists must be acquainted with the clinical features of MG as well as the medications administered in MG patients. AIM:The aim of the present study is to investigate and systematize the clinical presentations of MG in order to choose the most appropriate treatment approach and avoid complications. For this purpose, oral and maxillofacial clinicians must also be acquainted with the main groups of medications for this disease. MATERIALS AND METHODS: This research relied on Google Scholar and PubMed publications, published in the period 2000-2022.CONCLUSION: Myasthenia gravis is a serious and rare chronic disease. In order to avoid complications, some of which life-threatening, it is of utmost importance to know its main symptoms as well as applicable medications in dental treatment.

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Surgical Treatment of the Oroantral Fistula in a Patient with Myasthenia Gravis: Clinical Considerations and Anesthetical Management

Yıldırım,

Kazan,

Kılınç

et al. 2024

GMJ

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Anesthetic considerations for a patient with myasthenia gravis undergoing deep sedation in an outpatient oral surgery setting

Cited by 3 publications

References 13 publications

The Dental Management of Pediatric Patient Diagnosed with Myasthenia Gravis: A Case Report

The Dental Management of Pediatric Patient Diagnosed with Myasthenia Gravis: A Case Report

Preoperative management of patients with myasthenia gravis: a review article

Surgical Treatment of the Oroantral Fistula in a Patient with Myasthenia Gravis: Clinical Considerations and Anesthetical Management

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