1/5. Successful use of recombinant factor viia in a haemophiliac with inhibitor undergoing cataract surgery.A 40-year-old patient with severe haemophilia A and an inhibitor against factor viii underwent a cataract extraction under local anaesthesia. Recombinant activated factor VII was use to achieve haemostasis. The procedure was successful. Neither bleeding complications nor side effects occurred.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/5. Acute normovolemic haemodilution for management of 4200 ml blood loss during radical prostatectomy.BACKGROUND: We refer a case report of patient with 4200 ml large blood during urological surgery, in which was used acute normovolemic haemodilution as a solely method for avoiding of allogeneic blood transfusions. methods: A 65 years old patient was scheduled for radical prostatectomy. After starting general anaesthesia was removed 2360 g (target haematocrit 0.30 in patients with calculated total body blood volume 5460 ml) of whole blood from patient and circulation volume was replaced by 1500 ml of colloids and 2000 ml of crystalloid solution. Retransfusion was started after 1800 ml blood loss (transfusion trigger--Hct 0.20). RESULTS: The total blood loss was 4200 ml during 4 hour and 40 minutes of surgery. The patient was the whole operation time haemodynamic stable, with minimal systolic blood pressure 100 mmHg and haematocrit value was 0.32 after the procedure. CONCLUSIONS: To reduce the risk of anaemia and also the risk of allogeneic blood transfusion is the one of the basic part of the anaesthesia management of large urological procedures. This case demonstrated the effectiveness and safety of acute normovolemic haemodilution as a method for avoiding allogeneic blood transfusion in a patient with 77% loss of total body blood volume.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
3/5. Short-course use of recombinant factor viia in a haemophilia patient with inhibitor undergoing cataract surgeries.A 36 year-old patient with severe haemophilia A and high-titre inhibitor underwent cataract surgery under topical anaesthesia. Recombinant factor viia was used only three times, once before and twice following surgery. tranexamic acid was given concomitantly. One month after the first successful procedure on the right eye, a second operation was performed on the left eye in the same manner. Both procedures were uneventful. Neither bleeding complications nor any other side effects occurred.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/5. Extensive bleeding during surgical treatment for gingival overgrowth in a patient on haemodialysis--a case report and review of the literature.Before performing renal transplantation, a most important concern is to control any infection, including oral infections before transplantation. The bleeding diathesis of patients with uraemia is a significant clinical concern, especially when surgery is required. A 44-year-old female patient on haemodialysis was referred for evaluation of gingival overgrowth. The patient was planning a renal transplantation two months later. As the lesions were not considered successfully treatable before transplantation, a gingivectomy and teeth extraction was performed. In pre-operative examinations, an abnormal bleeding time was not detected and other coagulation tests were normal. Under general anaesthesia, 19 teeth were extracted and overgrown gingiva was removed. During the operation, extensive blood loss of 1650ml occurred and four units of concentrated red blood cells were transfused. This study suggests that patients with renal failure undergoing dental surgery require careful pre-surgical evaluation including assessment of their coagulation ability.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/5. Massive bleeding during spine surgery in a patient with ankylosing spondylitis.PURPOSE: Ankylosing spondylitis is associated with pathophysiology that has important anaesthetic implications. We report a case where the sequelae of ankylosing spondylitis may have been responsible for massive bleeding during emergency spine surgery. CLINICAL FEATURES: A 69 yr old man with long standing ankylosing spondylitis sustained a complex fracture of the lumbar spine in a fall, and was scheduled for stabilization of the spine. Under general anaesthesia, prone positioning was difficult because of the extreme spinal deformity. During exploration, dilatation of epidural veins was encountered and sustained haemorrhage was encountered throughout the surgical procedure. Estimated blood loss was 17,000 ml which was replaced with 31 units of packed red blood cells, 3200 ml of salvaged blood, 18 units of fresh frozen plasma, 26 units of platelets, 1,000 ml of albumin and 9,000 ml of crystalloid. CONCLUSIONS: Extreme deformity of the spine led to positioning difficulties that may have contributed to massive blood loss during complex spine surgery. Difficulties with placement in the prone position in-patients with advanced ankylosing spondylitis should be anticipated.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |