Yes, for most people whose myasthenia is well controlled. The surgeon, anaesthetist and neurologist plan the operation together before a date is set.
Keep taking your myasthenia tablets, including on the morning of surgery, unless the team tells you otherwise. Missing doses can bring on weakness.
Muscle relaxants used in anaesthesia act differently in myasthenia. The anaesthetist uses less, checks the effect with a monitor, and reverses it fully.
You have myasthenia gravis. Now a hernia needs repair, and you worry about the anaesthetic.
That worry is fair. But with planning, most people with steady myasthenia have the repair safely.
What myasthenia changes
In myasthenia, the signal from nerve to muscle is weak. Muscles tire quickly with use and recover with rest.
The muscles for breathing and swallowing can be affected too. That is why the anaesthetic needs care.
The hernia itself is no different. It is the plan around it that changes.
Choosing the right time
A hernia that is not causing trouble can wait for a calm spell. Your weakness should be steady, with no recent flare.
If you are weak, your neurologist may suggest a short course of treatment first, to build strength before the operation.
A stuck or very painful hernia cannot wait. It is repaired the same day, with extra care.
Planning hernia surgery with myasthenia gravis
Point to plan
Why it matters
What usually happens
Timing
Weakness should be steady, not in a flare
A planned repair waits for a calm spell
Myasthenia tablets
Missed doses can bring on weakness
Taken on time, even on the day
Muscle relaxants
The body reacts to them differently
Smaller doses, checked with a monitor
Some antibiotics and drips
A few can make weakness worse
The team chooses safer ones
Breathing after surgery
Weak breathing muscles tire easily
Close watch, sometimes in a high-care bed
Have myasthenia gravis and a hernia? Bring your neurologist's latest letter and your full medicine list with doses.
Keep taking your myasthenia tablets on time, including on the day of surgery. Bring them with you to hospital.
If you take steroid tablets, do not stop them. The team may give an extra dose around the operation.
Some other medicines can make weakness worse. These include certain antibiotics and some heart tablets. Show your full list so the team can check.
The anaesthetic and the repair
Muscle relaxants are drugs that keep the muscles still during surgery. In myasthenia they work differently. So the anaesthetist uses less and checks the effect with a monitor.
At the end, the effect is fully reversed. Your breathing is checked before the breathing tube comes out.
Some open groin repairs can be done under local anaesthetic with sedation. This avoids muscle relaxants. Keyhole repair needs a general anaesthetic.
After the operation
You are watched closely for the first day. Nurses check your breathing, swallowing and strength.
Some people stay in a high-care bed for a night. This is a precaution, not a sign that something went wrong.
Tell the nurse at once if your voice gets weak, swallowing is hard, or breathing feels heavy. Get up and walk as soon as you can, with rest in between.
What to bring
Bring your neurologist's latest letter and your medicine list with doses and times.
Bring any breathing test reports you have. Tell your neurologist you are seeing a hernia surgeon.
Frequently asked questions
Can I have a general anaesthetic with myasthenia gravis?
Yes, in most cases. The anaesthetist adjusts the muscle relaxants and checks your strength before you wake fully.
Should I stop my myasthenia tablets before surgery?
No. Keep taking them on time, including on the day of surgery, unless the team gives a different plan.
Is keyhole or open repair better with myasthenia?
Either can suit. Some open groin repairs can be done under local anaesthetic, which avoids muscle relaxants.
Will I need an intensive care bed after surgery?
Not always. Some people stay one night in a high-care bed as a precaution to watch breathing.
Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology) Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad Bring your reports. Second opinions are welcome.