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
C. McBeth and TGL. Watkins
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.
CASE REPORTS
Isoflurane for sedation in a case of congenital myasthenia gravis
Department of Anaesthesia, East Glamorgan Hospital, Church Village, Pontypridd, Mid Glamorgan CF38 1AB
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