Abstract
Children with mitochondrial disorders represent a subset of patients who require unique
anesthetic considerations. Routinely administered medications for general anesthesia,
such as propofol, have been shown to increase the risk of developing metabolic acidosis.
In addition, both depolarizing and nondepolarizing neuromuscular blockers are contraindicated
due to the risk of hyperkalemic cardiac arrest and worsening of preexisting muscle
weakness, respectively. These limitations pose challenges while choosing appropriate
medications for induction of general anesthesia, especially when the risk of aspiration
is high. We present a novel case of using inhaled sevoflurane and intravenous alfentanil
to facilitate intubation in a 4-year-old girl with a complex 1 mitochondrial disorder
suffering from severe gastroparesis and esophageal dysmotility.
Keywords
alfentanil - general anesthesia - mitochondrial disease
