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Anesthesia for children with mitochondrial disorders: a national survey and review

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Abstract

Purpose

Mitochondrial diseases are a heterogeneous group of disorders. Patients with such diseases often need general anesthesia for diagnostic procedures and surgery; guidelines are lacking for the anesthetic care of these patients.

Methods

We conducted a survey to investigate the current practices of pediatric anesthesiologists in the US in order to determine and document current practice. The survey consisted of twenty questions, including two demographic questions. A link to the survey was sent via email to members of the Society for Pediatric Anesthesia (2440), and was available online for 14 weeks.

Results

Only 503 completed the survey: a response rate of 20.61 %. Among the responders, 93.2 % had children with mitochondrial disorders among their patients, but only 11 % had institutional guidelines for such cases in place. Among the responders, 80.3 % used the standard nil per os (NPO) status guidelines, while the rest give intravenous dextrose solution once NPO was in effect. Only 18.3 % took precautions for malignant hyperthermia during treatment. The majority of the practitioners chose sevoflurane as the safest inhaled agent for induction and maintenance (89.7 and 78.5 %, respectively). Regional anesthesia was deemed safe by 97.3 % of the responders. Lactated Ringer’s solution was considered safe for these children by 49 %; only 47.8 % used dextrose-containing fluids for fluid replacement. The blood glucose was monitored by 72.7 %, and the majority (85 %) of this monitoring was done in a postanesthesia care unit.

Conclusion

Although the response rate was low, the majority of the responders provide care to these children routinely, so it can be inferred that the results of this survey are the closest published results to the true trend.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, University of Texas-Medical School at Houston, 6431 Fannin St., MSB 5.020, Houston, TX, 77030, USA

    Muhammad B. Rafique

  2. Department of Anesthesiology, University of Texas-Medical School at Houston, Houston, TX, USA

    Staci D. Cameron

  3. Department of Anesthesiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA

    Qaiser Khan

  4. Neurology Division, Center for Health Sciences, Oklahoma State University, Tulsa, OK, 74107, USA

    Salman Zubair

  5. Department of Neurology, University of Texas-Medical School at Houston, 6431 Fannin St., MSB 5.020, Houston, TX, 77030, USA

    Suur Biliciler

Authors
  1. Muhammad B. Rafique
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  2. Staci D. Cameron
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  3. Qaiser Khan
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  4. Suur Biliciler
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  5. Salman Zubair
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Corresponding author

Correspondence to Muhammad B. Rafique.

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Rafique, M.B., Cameron, S.D., Khan, Q. et al. Anesthesia for children with mitochondrial disorders: a national survey and review. J Anesth 27, 186–191 (2013). https://doi.org/10.1007/s00540-012-1488-1

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  • DOI: https://doi.org/10.1007/s00540-012-1488-1

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