Uemura Y, Kakuta N, Tanaka K, Tsutsumi YM. Anesthetic management of a patient with methylmalonic acidemia: a case report.
JA Clin Rep 2018;
4:71. [PMID:
32025901 PMCID:
PMC6966740 DOI:
10.1186/s40981-018-0209-7]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 09/24/2018] [Indexed: 11/28/2022] Open
Abstract
Background
Methylmalonic acidemia (MMA) is a metabolic disorder of organic acids and is characterized by the accumulation of methylmalonic acids.
Case presentation
The patient was a 19-year-old female diagnosed with severe MMA at 3 days of age, who was scheduled for renal replacement therapy. Preoperatively, there was no evidence of metabolic acidosis or electrolyte abnormalities. Glucose was administered preoperatively following a 6-h fast. Anesthesia was administered using thiamylal, remifentanil, rocuronium, and sevoflurane. After tracheal intubation, the patient underwent an ultrasound-guided bilateral rectus sheath block with ropivacaine. A drop in blood sugar level was treated with 5% glucose. Extubation was performed after intravenous administration of sugammadex.
Conclusions
We report the anesthetic management of a patient with MMA using a combination of general anesthesia and rectus sheath block.
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