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Anesthetic Effects in Mitochondrial Disease

Information source: The Cleveland Clinic
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Mitochondrial Disease

Intervention: sevoflurane (Drug)

Phase: N/A

Status: Terminated

Sponsored by: d sessler

Official(s) and/or principal investigator(s):
Danield I Sessler, MD, Study Chair, Affiliation: The Cleveland Clinic

Summary

Summary. At the present, the investigators do not have the perfect anesthetic for mitochondrial patients. When possible, consideration should be given to the use of local anesthetics in small amounts. When a general anesthetic is necessary, they each carry significant risks and have been associated with poor outcomes. At present it is not possible to eliminate one group as less safe than others. What is clear is that these patients must be monitored more closely than other patients. The advent of the bispectral index (BIS) monitor may allow us to monitor their depth of anesthesia more closely and thus expose these patients only to the minimum amount of drug necessary to carry out the surgical procedure. Purpose. The investigators hypothesize that specific mitochondrial diseases, in particular those that decrease complex I function, make certain children hypersensitive to volatile anesthetics. These same patients may be at increased risk for adverse outcomes following general anesthesia. The specific aims of this application are: 1. Determine which molecular defects in mitochondrial function lead to alter sensitivity to the VA sevoflurane. 2. Establish the relative safety of sevoflurane in treatment of patients with mitochondrial disease. The investigators plan to monitor patients with mitochondrial disease using expanded measures of cardiovascular stability and measurements of brain electrical activity while slowly inducing general anesthesia. The investigators will use those measurements to limit the amount of anesthetic these patients receive in an attempt to minimize their risk. In addition, the investigators will correlate their sensitivity to the type of mitochondrial defect so that the investigators may be able to predict which patients are likely to have an increased sensitivity.

Clinical Details

Official title: Anesthetic Effects in Mitochondrial Disease

Study design: Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Single Group Assignment, Masking: Double Blind (Caregiver, Investigator), Primary Purpose: Supportive Care

Primary outcome: Measure cardiovascular stability and electrical brain activity during slow induction with sevoflurane.

Secondary outcome: Use cardiovascular and electrical brain measurements to limit amount of sevoflurane and predict individual sensitivity.

Eligibility

Minimum age: 12 Months. Maximum age: 16 Years. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Patients presenting to the operating room for muscle biopsy as part of their

diagnostic workup for possible mitochondrial disease. Exclusion Criteria:

- Patients more than 16 years of age.

- Patients with concurrent acute infectious disease.

- Patients not tolerating a slow induction for emotional reasons.

- Initial BIS measurement of less than 95.

- Documented pulmonary disease.

Locations and Contacts

Cleveland Clinic, Cleveland, Ohio 44195, United States
Additional Information

Starting date: September 2006
Last updated: March 5, 2015

Page last updated: August 23, 2015

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