Implications of Mitochondrial Dysfunction for the Anesthetic and Perioperative Management: A Case Report of Spinal Fusion, Genetic Confusion, and a Patient's Perspective

We describe a patient's personal struggle with a symptom complex consisting of profound muscle weakness requiring pyridostigmine, and metabolic abnormalities suggestive of mitochondrial disease. This included a profound sensitivity to opioids, which in the past caused severe respiratory depression during a prior hospital admission. Interestingly, the patient herself is a professor of ethics in genomic sciences, and she and her medical team thus far have not been able to formally diagnose her with mitochondrial disease. The patient now presented for a multilevel lumbar spine fusion and her hospital course and perspective on her medical odyssey are described here.