Neuraxial anesthesia for extended endoscopic urological procedure in a patient with MELAS syndrome: a case report

Abstract

We present a case of a 36-years-old male patient with MELAS syndrome (Mitochondrial myopathy, Encephalopathy, Lactic acidosis, and Stroke-like episodes) underwent ureteroscopy, lithotripsy and indwelling double J stent exchange under neuraxial anesthesia. MELAS is a progressive mitochondrial myopathy that results in defects in respiratory enzyme complexes I and IV, which lead to defects in aerobic metabolism, thus endangering high-energy-dependent organs. MELAS causes a wide range of physiologic changes that present a variety of challenges to the anesthetists. In this case, we managed our patient safely with spinal/epidural anesthesia without any major complications. Abbreviations: MELAS - Mitochondrial myopathy, Encephalopathy, Lactic acidosis, and Stroke; MM - Mitochondrial myopathies; ATP - Adenosine triphosphate; ESWL - Extracorporeal shock wave lithotripsy; CPAP - Continuous positive airway pressure Key words: MELAS; Acidosis, Lactic / genetics; Anesthetic management; Mitochondrial myopathies; Neuraxial anesthesia: Genetics. Citation: Ababneh M, Al-Shehab R, Suleiman A. Neuraxial anesthesia for extended endoscopic urological procedure in a patient with MELAS syndrome: a case report. Anaesth. pain intensive care 2022;26(3):419-422. DOI: 10.35975/apic.v26i3.1754 Received: January 23, 2022; Reviewed: May 05, 2022; Accepted: May 30, 2022