The Immediate Postoperative Care of the Myasthenic Patient following Thymectomy.

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 tracheostomy 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. AntichoUnesterase drugs can be omitted for the first few days using the regimes which are suggested and the advantages of this are stressed. The detailed management of two cases is described.