[Anesthetic management of a patient with mitochondrial encephalomyopathy under total intravenous anesthesia].
This report describes a patient with mitochondrial encephalomyopathy who underwent tracheostomy under total intravenous anesthesia. This 15-year-old girl had been suffering from aspiration pneumonia repeatedly. Anesthesia was induced with propofol (30 mg) and fentanyl (50 microg), and the trachea was intubated without a muscle relaxant. The patient was mechanically ventilated also without a relaxant, and anesthesia was maintained with a continuous infusion of propofol 4-10 mg x kg(-1) x hr(-1) and a bolus injection of fentanyl 25 microg. Bispectral index (BIS) was monitored and maintained at 15-65. The patient showed smooth recovery from anesthesia, and the BIS value returned to the pre-anesthetic level 15 minutes after completion of the anesthesia. Her postoperative course was uneventful. We conclude that total intravenous anesthesia by propofol and fentanyl is a preferable method for the management of the patient with mitochondrial encephalomyopathy.
Tatsumi
Yumiko
Y
Department of Anesthesiology, Japanese Red Cross Nagoya First Hospital, Nagoya 453-8511.
Nakashima
Mashiho
M
Kitao
Takashi
T
Kan
Kojiro
K
Tomita
Takako
T
Hashimoto
Yuko
Y
Ema
Yoshiaki
Y
Kitagawa
Tomotaka
T
Oguri
Koichi
K
Yokota
Shuichi
S
D000293:Adolescent; D000771:Anesthesia, Intravenous / Q000379:methods*; D005260:Female; D006801:Humans; D017237:Mitochondrial Encephalomyopathies; D016343:Monitoring, Intraoperative; D015742:Propofol; D014140:Tracheotomy
D015742:Propofol