{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T18:44:39Z","timestamp":1783449879542,"version":"3.55.0"},"reference-count":28,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p>Mitochondrial disease (MD) represents a category of metabolic disorders with a wide range of symptoms across a variety of organ systems. It occurs with an incidence of greater than 1:5000 and can be difficult to specifically diagnose because of the variety of clinical presentations and multiple genomic origins. Although phenotypically variable, MD symptoms often include hypotonia, cardiac defects, dysautonomia, and metabolic dysfunction. Mitochondrial disease presents a unique challenge in terms of anesthetic management, as many anesthetic drugs suppress mitochondrial function. Additional considerations may need to be made in order to evaluate the patient's metabolic compensation prior to surgery. This article presents an in-depth discussion of a case involving a nearly 10-year-old boy with a history of an unspecified form of MD, who presented for endodontic treatment of tooth No. 30 under deep sedation. The article also provides a thorough review of the current literature surrounding the anesthetic management of patients with MD.<\/jats:p>","DOI":"10.2344\/anpr-63-03-08","type":"journal-article","created":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T16:13:35Z","timestamp":1485533615000},"page":"33-38","source":"Crossref","is-referenced-by-count":6,"title":["Anesthetic Management of a Child With Unspecified Mitochondrial Disease in an Outpatient Dental Setting"],"prefix":"10.2344","volume":"64","author":[{"given":"Taylor R.","family":"Gordon","sequence":"first","affiliation":[{"name":"Resident, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Montandon","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"key":"i0003-3006-64-1-33-b01","series-title":"Science","first-page":"1494","article-title":"Mutations causing mitochondrial disease: what is new and what challenges remain?","volume":"349","author":"Lightowlers \n              RN,","year":"2015","unstructured":"Lightowlers \n              RN, \n            \n            \n              Taylor \n              RW, \n            \n            \n              Turnbull \n              DM. \n            \n          \n          Mutations causing mitochondrial disease: what is new and what challenges remain?. Science. 2015;349:1494\u20131499."},{"key":"i0003-3006-64-1-33-b02","series-title":"Br J Anaesth","first-page":"436","article-title":"Mitochondrial disorders and general anesthesia: a case series and review","volume":"100","author":"Footitt \n              EJ,","year":"2008","unstructured":"Footitt \n              EJ, \n            \n            \n              Sinha \n              MD, \n            \n            \n              Raiman \n              JA, \n            \n            \n              Dhawan \n              A, \n            \n            \n              Moganasundram \n              S, \n            \n            \n              Champion \n              MP. \n            \n          \n          Mitochondrial disorders and general anesthesia: a case series and review. Br J Anaesth. 2008;100:436\u2013441."},{"key":"i0003-3006-64-1-33-b03","series-title":"Mol Genet Metab","first-page":"16","article-title":"The in-depth evaluation of suspected mitochondrial disease","volume":"94","author":"Falk \n              MJ,","year":"2008","unstructured":"Falk \n              MJ, \n            \n            \n              Saneto \n              RP, \n            \n            \n              Wolf \n              NI, \n            \n            et al. \n          The in-depth evaluation of suspected mitochondrial disease. Mol Genet Metab. 2008;94:16\u201337."},{"key":"i0003-3006-64-1-33-b04","series-title":"Anesthesia and Uncommon Diseases. 5th ed","first-page":"464","article-title":"Mitochondrial diseases","author":"Levy \n              RJ,","year":"2006","unstructured":"Levy \n              RJ, \n            \n            \n              Muravchick \n              S. \n            \n          \n          Mitochondrial diseases. In: Fleisher LA, ed. Anesthesia and Uncommon Diseases. 5th ed. Philadelphia, Pa: Saunders Elsevier;2006:464\u2013465."},{"key":"i0003-3006-64-1-33-b05","series-title":"J Child Neurol","first-page":"137","article-title":"Acute respiratory failure precipitated by general anesthesia in Leigh's syndrome","volume":"5","author":"Grattan-Smith \n              PJ,","year":"1990","unstructured":"Grattan-Smith \n              PJ, \n            \n            \n              Shield \n              LK, \n            \n            \n              Collins \n              KJ. \n            \n          \n          Acute respiratory failure precipitated by general anesthesia in Leigh's syndrome. J Child Neurol. 1990;5:137\u2013141."},{"key":"i0003-3006-64-1-33-b06","series-title":"Information for anesthesiologists and surgeons for operative and perioperative care of patients with mitochondrial diseases","author":"Kelley \n              RI.","year":"2009","unstructured":"Kelley \n              RI. \n            \n          \n          Information for anesthesiologists and surgeons for operative and perioperative care of patients with mitochondrial diseases\n          . Baltimore, Md: Kennedy Krieger Institute;\n          2009. Available at: http:\/\/www.mitoaction.org\/files\/Dr-Richard-Kellys-Mito-Anesthesia-document.pdf. Accessed January 4, 2016."},{"key":"i0003-3006-64-1-33-b07","series-title":"Malays J Pathol","first-page":"21","article-title":"Megat Yunus PJ, Yap S-F. Comparing measured total carbon dioxide and calculated bicarbonate","volume":"32","author":"Mohd Nasir \n              N,","year":"2010","unstructured":"Mohd Nasir \n              N, \n            \n            \n              Sthaneshwar \n              P, \n            \n          \n          Megat Yunus PJ, Yap S-F. Comparing measured total carbon dioxide and calculated bicarbonate. Malays J Pathol. 2010;32:21\u201326."},{"key":"i0003-3006-64-1-33-b08","series-title":"Ochsner J","first-page":"16","article-title":"Coenzyme Q10 and statin-induced mitochondrial dysfunction","volume":"10","author":"Deichmann \n              R,","year":"2010","unstructured":"Deichmann \n              R, \n            \n            \n              Lavie \n              C, \n            \n            \n              Andrews \n              S. \n            \n          \n          Coenzyme Q10 and statin-induced mitochondrial dysfunction. Ochsner J. 2010;10:16\u201321."},{"key":"i0003-3006-64-1-33-b09","series-title":"Monroeville, Pa: United Mitochondrial Disease Foundation; 2006","article-title":"Anesthetic considerations in mitochondrial diseases","author":"Sirrs \n              S,","unstructured":"Sirrs \n              S, \n            \n            \n              Duncan \n              P. \n            \n          \n          Anesthetic considerations in mitochondrial diseases. In: O'Riley M, ed. Monroeville, Pa: United Mitochondrial Disease Foundation; 2006. Available at: http:\/\/www.mito-matters.org.uk\/wp-content\/uploads\/2012\/02\/Anesthetic-Considerations-in-Mitochondrial-Disease.pdf. Accessed August 21, 2015."},{"key":"i0003-3006-64-1-33-b10","series-title":"AANA J","first-page":"237","article-title":"Mitochondrial diseases and anesthesia: a literature review of current opinions","volume":"81","author":"Rivera-Cruz \n              B.","year":"2013","unstructured":"Rivera-Cruz \n              B. \n            \n          \n          Mitochondrial diseases and anesthesia: a literature review of current opinions. AANA J. 2013;81:237\u2013243."},{"key":"i0003-3006-64-1-33-b11","series-title":"Anesthesia and mitochondrial cytopathies","author":"Cohen \n              BH,","year":"1998","unstructured":"Cohen \n              BH, \n            \n            \n              Shoffner \n              J, \n            \n            \n              DeBoer \n              G. \n            \n          \n          Anesthesia and mitochondrial cytopathies\n          . Monroeville, Pa: United Mitochondrial Disease Foundation;\n          1998. Available at: http:\/\/www.emdn-mitonet.co.uk\/pdf\/mitoane.pdf. Accessed January 6, 2016."},{"key":"i0003-3006-64-1-33-b12","series-title":"Anesthesiology","first-page":"1635","article-title":"Positive malignant hyperthermia susceptibility in vitro test in a patient with mitochondrial myopathy and myoadenylate deaminase deficiency","volume":"97","author":"Fricker \n              RM,","year":"2002","unstructured":"Fricker \n              RM, \n            \n            \n              Raffelsberger \n              T, \n            \n            \n              Rauch-Shorny \n              S, \n            \n            et al. \n          Positive malignant hyperthermia susceptibility in vitro test in a patient with mitochondrial myopathy and myoadenylate deaminase deficiency. Anesthesiology. 2002;97:1635\u20131637."},{"key":"i0003-3006-64-1-33-b13","series-title":"Anesthesiology","first-page":"819","article-title":"Clinical implications of mitochondrial dysfunction","volume":"105","author":"Muravchick \n              S,","year":"2006","unstructured":"Muravchick \n              S, \n            \n            \n              Levy \n              RJ. \n            \n          \n          Clinical implications of mitochondrial dysfunction. Anesthesiology. 2006;105:819\u2013837."},{"key":"i0003-3006-64-1-33-b14","series-title":"Br J Anaesth","first-page":"397","article-title":"Anesthesia and the sex-linked dystrophies: between a rock and a hard place","volume":"104","author":"Hopkins \n              PM.","year":"2010","unstructured":"Hopkins \n              PM. \n            \n          \n          Anesthesia and the sex-linked dystrophies: between a rock and a hard place. Br J Anaesth. 2010;104:397\u2013400."},{"key":"i0003-3006-64-1-33-b15","series-title":"A Practice of Anesthesia for Infants and Children. 5th ed","article-title":"Pharmacokinetics and pharmacology of drugs used in children","author":"Cote \n              CJ,","year":"2013","unstructured":"Cote \n              CJ, \n            \n            \n              Lerman \n              J, \n            \n            \n              Anderson \n              BJ. \n            \n          \n          Pharmacokinetics and pharmacology of drugs used in children. In: A Practice of Anesthesia for Infants and Children. 5th ed. Philadelphia, Pa: Saunders Elsevier;2013:129."},{"key":"i0003-3006-64-1-33-b16","series-title":"J Clin Anesth","first-page":"524","article-title":"Anesthesia for a child with complex I respiratory chain enzyme deficiency","volume":"10","author":"Cheam \n              EWS,","year":"1998","unstructured":"Cheam \n              EWS, \n            \n            \n              Critchley \n              LAH. \n            \n          \n          Anesthesia for a child with complex I respiratory chain enzyme deficiency. J Clin Anesth. 1998;10:524\u2013527."},{"key":"i0003-3006-64-1-33-b17","series-title":"Paediatr Anaesth","first-page":"785","article-title":"Anesthetic considerations in patients with mitochondrial defects","volume":"23","author":"Niezgoda \n              J,","year":"2013","unstructured":"Niezgoda \n              J, \n            \n            \n              Morgan \n              PG. \n            \n          \n          Anesthetic considerations in patients with mitochondrial defects. Paediatr Anaesth. 2013;23:785\u2013793."},{"key":"i0003-3006-64-1-33-b18","series-title":"Paediatr Anaesth","first-page":"1","article-title":"Muscular dystrophy versus mitochondrial myopathy: the dilemma of the undiagnosed hypotonic child","volume":"17","author":"Ross \n              AK.","year":"2006","unstructured":"Ross \n              AK. \n            \n          \n          Muscular dystrophy versus mitochondrial myopathy: the dilemma of the undiagnosed hypotonic child. Paediatr Anaesth. 2006;17:1\u20136."},{"key":"i0003-3006-64-1-33-b19","series-title":"Paediatr Anaesth","first-page":"16","article-title":"Anesthesia-related morbidity and mortality after surgery for muscle biopsy in children with mitochondrial defects","volume":"17","author":"Driessen \n              J,","year":"2007","unstructured":"Driessen \n              J, \n            \n            \n              Willems \n              S, \n            \n            \n              Dercksen \n              S, \n            \n            \n              Giele \n              J, \n            \n            \n              van der Staak \n              F, \n            \n            \n              Smeitink \n              J. \n            \n          \n          Anesthesia-related morbidity and mortality after surgery for muscle biopsy in children with mitochondrial defects. Paediatr Anaesth. 2007;17:16\u201321."},{"key":"i0003-3006-64-1-33-b20","series-title":"IUBMB Life","first-page":"273","article-title":"Mitochondria as a pharmacological target: magnum overview","volume":"65","author":"Olszewska \n              A,","year":"2013","unstructured":"Olszewska \n              A, \n            \n            \n              Szewczyk \n              A. \n            \n          \n          Mitochondria as a pharmacological target: magnum overview. IUBMB Life. 2013;65:273\u2013281."},{"key":"i0003-3006-64-1-33-b21","series-title":"Int J Biochem Cell Biol","first-page":"14","article-title":"From analgesia to myopathy: when local anesthetics impair the mitochondrion","volume":"43","author":"Nouette-Gaulain \n              K,","year":"2011","unstructured":"Nouette-Gaulain \n              K, \n            \n            \n              Jose, \n              C, \n            \n            \n              Capdevila \n              X, \n            \n            \n              Rossignol \n              R. \n            \n          \n          From analgesia to myopathy: when local anesthetics impair the mitochondrion. Int J Biochem Cell Biol. 2011;43:14\u201319."},{"key":"i0003-3006-64-1-33-b22","series-title":"Paediatr Anaesth","first-page":"488","article-title":"Anaesthetic considerations for a child with combined Prader\u2013Willi syndrome and mitochondrial myopathy","volume":"11","author":"Sharma \n              AD,","year":"2001","unstructured":"Sharma \n              AD, \n            \n            \n              Erb \n              T, \n            \n            \n              Schulman \n              SR, \n            \n            \n              Sreeram \n              G, \n            \n            \n              Slaughter \n              TF. \n            \n          \n          Anaesthetic considerations for a child with combined Prader\u2013Willi syndrome and mitochondrial myopathy. Paediatr Anaesth. 2001;11:488\u2013490."},{"key":"i0003-3006-64-1-33-b23","series-title":"Anesth Analg","first-page":"1404","article-title":"Anesthetic considerations in patients presenting with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome","volume":"85","author":"Thompson \n              VA,","year":"1997","unstructured":"Thompson \n              VA, \n            \n            \n              Wahr \n              JA. \n            \n          \n          Anesthetic considerations in patients presenting with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome. Anesth Analg. 1997;85:1404\u20131406."},{"key":"i0003-3006-64-1-33-b24","series-title":"Paediatr Anaesth","first-page":"249","article-title":"Anaesthesia and mitochondrial disease","volume":"8","author":"Wallace \n              JJ,","year":"1998","unstructured":"Wallace \n              JJ, \n            \n            \n              Perndt \n              H, \n            \n            \n              Skinner \n              M. \n            \n          \n          Anaesthesia and mitochondrial disease. Paediatr Anaesth. 1998;8:249\u2013254."},{"key":"i0003-3006-64-1-33-b25","series-title":"Anesth Analg","first-page":"320","article-title":"Acute ketamine impairs mitochondrial function and promotes superoxide dismutase activity in the rat brain","volume":"120","author":"Ven\u00e2ncio \n              C,","year":"2015","unstructured":"Ven\u00e2ncio \n              C, \n            \n            \n              F\u00e9lix \n              L, \n            \n            \n              Almeida \n              V, \n            \n            et al. \n          Acute ketamine impairs mitochondrial function and promotes superoxide dismutase activity in the rat brain. Anesth Analg. 2015;120:320\u2013328."},{"key":"i0003-3006-64-1-33-b26","series-title":"Anesth Analg","first-page":"917","article-title":"Ketamine and mitochondrial function","volume":"122","author":"Morgan \n              PG.","year":"2016","unstructured":"Morgan \n              PG. \n            \n            \n              Sedensky \n              MM, \n            \n            \n              Kayser \n              E. \n            \n          \n          Ketamine and mitochondrial function. Anesth Analg. 2016;122:917\u2013918."},{"key":"i0003-3006-64-1-33-b27","series-title":"UpToDate","article-title":"Inborn errors of metabolism: metabolic emergencies","author":"Sutton \n              VR.","year":"2016","unstructured":"Sutton \n              VR. \n            \n          \n          Inborn errors of metabolism: metabolic emergencies. In: Hahn S, TePas E, eds. UpToDate. Waltham, Ma: Wolters Kluwer. Available at: http:\/\/www.uptodate.com\/contents\/inborn-errors-of-metabolism-metabolic-emergencies. Accessed April 21, 2016."},{"key":"i0003-3006-64-1-33-b28","series-title":"Biochim Biophys Acta","first-page":"115","article-title":"The epidemiology of mitochondrial disorders\u2014past, present and future","volume":"1659","author":"Schaefer \n              AM,","year":"2004","unstructured":"Schaefer \n              AM, \n            \n            \n              Taylor \n              RW, \n            \n            \n              Turnbull \n              DM, \n            \n            \n              Chinnery \n              PF. \n            \n          \n          The epidemiology of mitochondrial disorders\u2014past, present and future. Biochim Biophys Acta. 2004;1659:115\u2013120."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/64\/1\/article-p33.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/64\/1\/33\/2099962\/anpr-63-03-08.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/64\/1\/article-p33.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/64\/1\/article-p33.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:37:50Z","timestamp":1728304670000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/64\/1\/article-p33.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":28,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.2344\/anpr-63-03-08","relation":{},"ISSN":["0003-3006","1878-7177"],"issn-type":[{"value":"0003-3006","type":"print"},{"value":"1878-7177","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017]]}}}