Anesthetic management of a patient with mitochondrial encephalomyopathy under total intravenous anesthesia |
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Authors: | Tatsumi Yumiko Nakashima Mashiho Kitao Takashi Kan Kojiro Tomita Takako Hashimoto Yuko Ema Yoshiaki Kitagawa Tomotaka Oguri Koichi Yokota Shuichi |
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Affiliation: | Department of Anesthesiology, Japanese Red Cross Nagoya First Hospital, Nagoya 453-8511. |
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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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