Document Detail


Anesthetic management of a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) during laparotomy.
MedLine Citation:
PMID:  17285419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 53-year-old man with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) underwent a gastrectomy. We administered bicarbonated Ringer's solution, which has a physiological concentration of bicarbonate. The level of serum lactate did not increase significantly, and metabolic acidosis did not occur throughout surgery or for 3 h after surgery. Aggressive warming was needed to maintain normothermia, presumably because the mitochondrial respiratory chain, which is responsible for thermogenesis, is impaired in MELAS patients. It is important to maintain normothermia in MELAS patients in order to avoid further mitochondrial metabolic depression.
Authors:
Nobuko Sasano; Yoshihito Fujita; Minhye So; Kazuya Sobue; Hiroshi Sasano; Hirotada Katsuya
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-01-30
Journal Detail:
Title:  Journal of anesthesia     Volume:  21     ISSN:  0913-8668     ISO Abbreviation:  J Anesth     Publication Date:  2007  
Date Detail:
Created Date:  2007-02-07     Completed Date:  2007-04-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  72-5     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8622, Japan.
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MeSH Terms
Descriptor/Qualifier:
Amides / administration & dosage
Anesthesia / methods*
Anesthesia, Epidural / methods
Anesthetics, Intravenous / administration & dosage
Anesthetics, Local / administration & dosage
Blood Gas Analysis / methods
Body Temperature / drug effects
Diabetes Mellitus, Type 1 / complications
Fentanyl / administration & dosage
Gastrectomy / methods*
Humans
Intubation, Intratracheal / methods
Isotonic Solutions / administration & dosage
Lactic Acid / blood
Lidocaine / administration & dosage
MELAS Syndrome / complications,  surgery*
Male
Middle Aged
Neuromuscular Nondepolarizing Agents / administration & dosage
Propofol / administration & dosage
Stomach Neoplasms / complications,  surgery*
Time Factors
Vecuronium Bromide / administration & dosage
Chemical
Reg. No./Substance:
0/Amides; 0/Anesthetics, Intravenous; 0/Anesthetics, Local; 0/Isotonic Solutions; 0/Neuromuscular Nondepolarizing Agents; 0/bicarbonated Ringer's solution; 137-58-6/Lidocaine; 2078-54-8/Propofol; 437-38-7/Fentanyl; 50-21-5/Lactic Acid; 50700-72-6/Vecuronium Bromide; 84057-95-4/ropivacaine

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