[Anesthetic management of a patient with mitochondrial encephalomyopathy]

A 46-year-old female with mitochondrial encephalomyopathy underwent the replacement of right femur head under continuous epidural anesthesia. Considering that this disease is a neuromuscular disorder, general anesthesia should be avoided. In addition, the patients with mitochondrial encephalomyopathy tend to show increased concentrations of lactate and pyruvate caused by perioperative stress. Use of lactated Ringer's solution may elevate these concentrations. We managed this patient uneventfully with continuous epidural anesthesia and the use of acetated Ringer's solution during the perioperative period. We consider that continuous epidural anesthesia is useful for a patient with mitochondrial encephalomyopathy.