Question

A 14-kg, 3-year-old boy is scheduled for bilateral inguinal herniorrhaphy. With which of the following coexisting diseases would a total intravenous anesthetic technique be most appropriate?

A. Duchenne muscular dystrophy
B. Central core disease
C. Mitochondrial myopathy
D. Becker muscular dystrophy
E. Myotonia congenita

Answer 1

For a 3-year-old boy with a coexisting disease undergoing bilateral inguinal herniorrhaphy, a total intravenous anesthetic technique is most appropriate in the case of mitochondrial myopathy. This approach avoids the exacerbation of the condition that could be caused by volatile anesthetic agents.

Step-by-step explanation:

The question is inquiring which coexisting disease would make a total intravenous anesthetic technique most appropriate for a 3-year-old boy scheduled for bilateral inguinal herniorrhaphy. Among the options provided, mitochondrial myopathy is the condition for which a total intravenous anesthetic (TIVA) technique would be most appropriate. This choice is based on the avoidance of volatile anesthetic agents which may exacerbate the condition by affecting mitochondrial function. Furthermore, TIVA can be beneficial as it allows for a tailored approach to anesthesia, minimizing metabolic stress on the muscle cells which are already compromised in mitochondrial myopathy. In contrast, diseases such as Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) involve a risk of malignant hyperthermia and other complications when using inhalational anesthetics, but other anesthetic considerations need to be addressed for these diseases as well, notably the potential for cardiomyopathy.