PERIOPERATIVE MANAGEMENT OF CAESAREAN SECTION IN A PARTURIENT WITH MITOCHONDRIAL MYOPATHY

Abstract

Mitochondrial myopathies, one type of mitochondrial disease, usually result in clinical disorders of the muscle and other tissues that require a high energy supply, resulting in clinical manifestations such as fatigue, muscle weakness and exercise intolerance which were present in our patient. The optimal anaesthetic technique for these patients is not known but we decided to administer SA. Besides ameliorating metabolic stress and pain which can be detrimental in these patients, it helped avoid general anaesthetics(most anaesthetic drugs have depressant effects on mitochondrial function), sedatives and muscle relaxants which have the potential to cause postoperative residual muscle blockade and thus respiratory compromise due to the increased sensitivity described in them anaesthetics. Women with mitochondrial disease are likely to experience a variable clinical course before, during and after pregnancy. Multidisciplinary care (mitochondrial medicine, neurology) is indicated in these parturients. The anaesthesiologists should be aware of the disease, its possible varied presentation and the multiple anaesthetic implications. Benefit of surgery should justify the anaesthetic risk.