Isoflurane for sedation in a case of congenital myasthenia gravis

British Journal of Anaesthesia
C McBeth, T G Watkins

Abstract

We describe the use of isoflurane for the management of a 3-yr-old boy with congenital myasthenia gravis who required ventilation for pneumonia. While in the intensive care unit he was sedated with isoflurane for 5 days (81 MAC-h). This provided a safe, easily controllable method of sedation which avoided the use of neuromuscular blocking agents and appeared to have no significant side effects during use. However, after it was stopped the patient developed a fine, self-limiting tremor which lasted for 2 days. Previous reports of paediatric patients sedated with isoflurane suggest that prolonged exposure may result in temporary dose-dependent neurological dysfunction, including hallucinations, ataxia and non-purposeful movements.

Citations

Nov 14, 2007·Der Anaesthesist·C SirtlA Meiser
Feb 21, 2003·British Journal of Anaesthesia·A MeiserH J Laubenthal
Feb 4, 2009·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Mary E HartmanScott R Schulman
Mar 30, 2013·Critical Care Clinics·Ryan Wilkes, Robert C Tasker
Mar 5, 2011·European Journal of Anaesthesiology·Andrea GentiliSimonetta Baroncini
May 24, 2008·Anesthesia and Analgesia·Andreas W Loepke, Sulpicio G Soriano
Oct 15, 2014·Current Opinion in Pediatrics·Robert C Tasker, Sally H Vitali
Jun 19, 2007·British Journal of Anaesthesia·N P Hirsch

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