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  • Title: [Anesthetic management of a patient with mitochondrial encephalomyopathy under total intravenous anesthesia].
    Author: Tatsumi Y, Nakashima M, Kitao T, Kan K, Tomita T, Hashimoto Y, Ema Y, Kitagawa T, Oguri K, Yokota S.
    Journal: Masui; 2006 Oct; 55(10):1228-30. PubMed ID: 17051981.
    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.
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