Peri-operative management of a child with juvenile myasthenia gravis undergoing thoracoscopic thymectomy - a case report

Juvenile myasthenia gravis (JMG) is a rare autoimmune disease of children. Thymic hyperplasia is more common in JMG and patients with refractory symptoms benefit from thymectomy. This reports a successful thoracoscopic thymectomy without lung isolation in a 13-year old with JMG. This technique allowed faster recovery with less post-operative complications. The anaesthetic challenges associated with neuromuscular blocking agents were safely overcome by non muscle relaxant technique by the use of potent opioid remifentanyl combined with anaesthetic agents.