Intrathecal morphine for thymectomy in a morbidly obese patient with myasthenia gravis.

Postoperative respiratory management in a patient with myasthenia gravis is a difficult problem because of underlying muscle weakness, residual effects of anesthesia, and incisional pain. Use of intrathecal morphine reduces the amount of inhalation agent needed and provides analgesia for the first postoperative day, leading to a prompt, smooth emergence and easy extubation.