Anaesthetic management of bronchopleural fistula in a patient with myasthenia gravis

Singh P, Poopalalingam R
Correspondence: Dr Paramvir Singh, drsinghparamvir@gmail.com

ABSTRACT
Patients with bronchopleural fistula present with specific airway management and ventilatory concerns, which makes the anaesthetic management of these patients challenging. Myasthenia gravis is another condition requiring specific anaesthetic management, with possible unpredictable delays in recovery. A combination of both these conditions in a patient makes management even more difficult. Our patient with myasthenia gravis underwent repair of the bronchopleural fistula, during which a multimodal approach to intraoperative and postoperative analgesia was adopted. Positive pressure ventilation was started only after we confirmed the isolation of the lung.

Keywords: anaesthetic management, bronchopleural fistula, desflurane, double lumen tube, myasthenia gravis
Singapore Med J 2011; 52(5): e100-e101