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British Journal of Anaesthesia, Vol 77, Issue 5 672-674, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia


CASE REPORTS

Isoflurane for sedation in a case of congenital myasthenia gravis

C. McBeth and TGL. Watkins
Department of Anaesthesia, East Glamorgan Hospital, Church Village, Pontypridd, Mid Glamorgan CF38 1AB

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.
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