title: [Anesthetic management of a patient with mitochondrial encephalomyopathy under total intravenous anesthesia].
abstract: 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.
authors.affiliation: Department of Anesthesiology, Japanese Red Cross Nagoya First Hospital, Nagoya 453-8511.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Tatsumi
authors.forename: Mashiho
authors.initials: M
authors.lastname: Nakashima
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitao
authors.forename: Kojiro
authors.initials: K
authors.lastname: Kan
authors.forename: Takako
authors.initials: T
authors.lastname: Tomita
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ema
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Kitagawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Oguri
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yokota
mesh_terms: D000293:Adolescent; D000771:Anesthesia, Intravenous / Q000379:methods*; D005260:Female; D006801:Humans; D017237:Mitochondrial Encephalomyopathies; D016343:Monitoring, Intraoperative; D015742:Propofol; D014140:Tracheotomy
chemical_list: D015742:Propofol