Resistance to cisatracurium in a patient with MELAS syndrome.
There are conflicting reports on the response of mitochondrial myopathy patients to the neuromuscular blocking drugs, showing either normal response or marked sensitivity. We present a patient with MELAS syndrome who underwent Nissen fundoplication and gastrojejunostomy. Marked resistance to the nondepolarizing muscle relaxant, cisatracurium was observed. The anesthesia management, as well as the various causes of resistance to cisatracurium in this patient are discussed.
Aouad
Marie T
MT
Department of Anaesthesiology, American University of Beirut Medical Centre, Beirut, Lebanon. mm01@aub.edu.lb
Gerges
Frederic J
FJ
Baraka
Anis S
AS
D000293:Adolescent; D001279:Atracurium / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013505:Digestive System Surgical Procedures; D004351:Drug Resistance; D005260:Female; D006801:Humans; D017241:MELAS Syndrome / Q000503:physiopathology / Q000601:surgery*; D009469:Neuromuscular Junction / Q000187:drug effects / Q000503:physiopathology; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D009435:Synaptic Transmission / Q000187:drug effects
D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; C101584:cisatracurium