Gordon Taylor R, Montandon Richard J
Resident, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania.
Assistant Professor, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania.
Anesth Prog. 2017 Spring;64(1):33-38. doi: 10.2344/anpr-63-03-08.
Mitochondrial disease (MD) represents a category of metabolic disorders with a wide range of symptoms across a variety of organ systems. It occurs with an incidence of greater than 1:5000 and can be difficult to specifically diagnose because of the variety of clinical presentations and multiple genomic origins. Although phenotypically variable, MD symptoms often include hypotonia, cardiac defects, dysautonomia, and metabolic dysfunction. Mitochondrial disease presents a unique challenge in terms of anesthetic management, as many anesthetic drugs suppress mitochondrial function. Additional considerations may need to be made in order to evaluate the patient's metabolic compensation prior to surgery. This article presents an in-depth discussion of a case involving a nearly 10-year-old boy with a history of an unspecified form of MD, who presented for endodontic treatment of tooth No. 30 under deep sedation. The article also provides a thorough review of the current literature surrounding the anesthetic management of patients with MD.
线粒体疾病（MD）是一类代谢紊乱疾病，在各种器官系统中具有广泛的症状。其发病率高于1:5000，由于临床表现多样且基因组起源多样，可能难以进行特异性诊断。尽管MD的表型存在差异，但其症状通常包括肌张力减退、心脏缺陷、自主神经功能障碍和代谢功能障碍。线粒体疾病在麻醉管理方面带来了独特的挑战，因为许多麻醉药物会抑制线粒体功能。为了在手术前评估患者的代谢代偿情况，可能需要进行额外的考虑。本文深入讨论了一个病例，该病例涉及一名近10岁的男孩，有未明确形式的MD病史，前来接受30号牙的牙髓治疗，在深度镇静下进行。本文还全面回顾了目前有关MD患者麻醉管理的文献。
