THE IMMEDIATE POSTOPERATIVE CARE OF THE MYASTHENIC PATIENT FOLLOWING THYMECTOMY

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Abstract
The problems which arise in dealing with the myasthenic patient in the immediate postoperative period following thymectomy are discussed. The indications for and advantages of spontaneous ventilation, elective tracheostotny and intermittent positive pressure ventilation are considered and the benefits of managing all such cases in an intensive care unit are stressed. It is considered that only in patients in whom the disease is limited to overt involvement of the limb and eye muscles is a trial of spontaneous ventilation indicated. Anticholinesterase drugs can be omitted for the first few days using the régimes which are suggested and the advantages of this are stressed. The detailed management of two cases is described.