[Total intravenous anesthesia for a patient with mitochondrial encephalomyopathy who underwent laparoscopic...

A 49-year-old female with mitochondrial encephalomyopathy underwent laparoscopic cholecystotomy. She had some characteristic clinical symptoms, including muscle weakness, deafness, hemianopia and elevation of lactic acid level in the blood. It has been considered that problems of anesthesia for patient with mitochondrial encephalomyopathy are relevant to malignant hyperthermia, respiratory depression due to muscle weakness and probability of hyperlactacidemia. Anesthesia was induced with propofol, remifentanil and rocuronium, and maintained with continuous infusion of propofol and remifentanil, with administration of rocuronium under neuromuscular monitoring throughout the surgery. Arterial blood gases and pH were checked and acetated electrolyte solution was infused mainly during surgery. No complications occurred during anesthesia and this patient showed smooth recovery from anesthesia. Her postoperative course was uneventful.