• Yumiko Tatsumi, Mashiho Nakashima, Takashi Kitao, Kojiro Kan, Takako Tomita, Yuko Hashimoto, Yoshiaki Ema, Tomotaka Kitagawa, Koichi Oguri, and Shuichi Yokota.
• Department of Anesthesiology, Japanese Red Cross Nagoya First Hospital, Nagoya 453-8511.
• Masui. 2006 Oct 1; 55 (10): 1228-30.

AbstractThis 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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