Ventilatory support using bilevel positive airway pressure during neuraxial blockade in a patient with severe respiratory compromise.

Abstract

In pregnant patients with myasthenia gravis and respiratory compromise, neuraxial anesthesia for lower abdominal surgery can risk further respiratory depression. We report the use of epidural anesthesia for dilation and curettage and tubal ligation in a 26-yr-old woman with a 12-wk intrauterine pregnancy with severe myasthenia gravis and respiratory insufficiency in whom ventilatory support during anesthesia was provided successfully using bilevel positive airway pressure ventilation. This report demonstrates how the use of bilevel positive airway pressure for ventilatory support may improve the safety of regional anesthesia in patients with severe respiratory compromise.