Suzuki Yuji, Doi Matsuyuki, Nakajima Yoshiki
Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3192, Japan.
JA Clin Rep. 2021 Jun 23;7(1):51. doi: 10.1186/s40981-021-00454-8.
Systemic anesthetic management of patients with mitochondrial disease requires careful preoperative preparation to administer adequate anesthesia and address potential disease-related complications. The appropriate general anesthetic agents to use in these patients remain controversial.
A 54-year-old woman (height, 145 cm; weight, 43 kg) diagnosed with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes underwent elective cochlear implantation. Infusions of intravenous remimazolam and remifentanil guided by patient state index monitoring were used for anesthesia induction and maintenance. Neither lactic acidosis nor prolonged muscle relaxation occurred in the perioperative period. At the end of surgery, flumazenil was administered to antagonize sedation, which rapidly resulted in consciousness.
Remimazolam administration and reversal with flumazenil were successfully used for general anesthesia in a patient with mitochondrial disease.
线粒体疾病患者的全身麻醉管理需要仔细的术前准备，以给予充分的麻醉并应对潜在的疾病相关并发症。在这些患者中使用何种合适的全身麻醉药物仍存在争议。
一名54岁女性（身高145厘米；体重43千克），被诊断为患有线粒体脑肌病伴乳酸酸中毒和卒中样发作，接受了择期人工耳蜗植入术。在患者状态指数监测的引导下，静脉输注瑞马唑仑和瑞芬太尼用于麻醉诱导和维持。围手术期未发生乳酸酸中毒或肌肉松弛延长。手术结束时，给予氟马西尼拮抗镇静作用，患者迅速恢复意识。
瑞马唑仑给药及氟马西尼逆转成功用于一名线粒体疾病患者的全身麻醉。
