Patient with von Willebrand Disease for Gynaecologic Surgery - Perianaesthetic Concerns

We report a case of von Willebrand (vWD) disease and highlight the relevance of this condition to the perianaesthetic management.A 23-year-old female, known case of vWD diagnosed at 3 years of age, was posted for laparoscopic ovarian cystectomy. Pre-induction, patient was transfused with cryoprecipi...

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Main Authors: Rakesh Garg, Mridu Paban Nath, Sanjay Verma, Ashwani Kumar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2008-01-01
Series:Indian Journal of Anaesthesia
Subjects:
Online Access:http://www.ijaweb.org/article.asp?issn=0019-5049;year=2008;volume=52;issue=5;spage=573;epage=573;aulast=Garg
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author Rakesh Garg
Mridu Paban Nath
Sanjay Verma
Ashwani Kumar
author_facet Rakesh Garg
Mridu Paban Nath
Sanjay Verma
Ashwani Kumar
author_sort Rakesh Garg
collection DOAJ
description We report a case of von Willebrand (vWD) disease and highlight the relevance of this condition to the perianaesthetic management.A 23-year-old female, known case of vWD diagnosed at 3 years of age, was posted for laparoscopic ovarian cystectomy. Pre-induction, patient was transfused with cryoprecipitate 10units. Standard tech-nique of anaesthesia was followed with intraoperative cryoprecipitate administration. Surgery was uneventful with adequate hemostasis. Post-operatively analgesia was maintained with morphine patient controlled analgesia(PCA). All intra-muscular injections were avoided. She was transfused with cryoprecipitate/ fresh frozen plasma(FFP) till 5th day and injection tranexamic acid was administered. Postoperative serum coagulation studies were within normal limits. Patients with vWD do not carry an increased operative risk during elective procedures if appropriate prophylac-tic and corrective therapy is administered. Although the administration of cryoprecipitate and other blood products has traditionally been the cornerstone of treatment for vWD, the recent development of desmopressin(DDAVP) for clinical use may provide an effective alternative to replacement therapy with blood products. Further laparaoscopic procedures, taking care during ryle′s tube and foley′s catheter insertion, in such patients are the safer alternative for all kind of gynecologic surgeries.
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spelling doaj.art-271854a673fc4d6298531edb40e64aed2022-12-21T19:48:15ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50492008-01-01525573573Patient with von Willebrand Disease for Gynaecologic Surgery - Perianaesthetic ConcernsRakesh GargMridu Paban NathSanjay VermaAshwani KumarWe report a case of von Willebrand (vWD) disease and highlight the relevance of this condition to the perianaesthetic management.A 23-year-old female, known case of vWD diagnosed at 3 years of age, was posted for laparoscopic ovarian cystectomy. Pre-induction, patient was transfused with cryoprecipitate 10units. Standard tech-nique of anaesthesia was followed with intraoperative cryoprecipitate administration. Surgery was uneventful with adequate hemostasis. Post-operatively analgesia was maintained with morphine patient controlled analgesia(PCA). All intra-muscular injections were avoided. She was transfused with cryoprecipitate/ fresh frozen plasma(FFP) till 5th day and injection tranexamic acid was administered. Postoperative serum coagulation studies were within normal limits. Patients with vWD do not carry an increased operative risk during elective procedures if appropriate prophylac-tic and corrective therapy is administered. Although the administration of cryoprecipitate and other blood products has traditionally been the cornerstone of treatment for vWD, the recent development of desmopressin(DDAVP) for clinical use may provide an effective alternative to replacement therapy with blood products. Further laparaoscopic procedures, taking care during ryle′s tube and foley′s catheter insertion, in such patients are the safer alternative for all kind of gynecologic surgeries.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2008;volume=52;issue=5;spage=573;epage=573;aulast=Gargvon Willebrand diseasevon Willebrand factorCoagulopathy.
spellingShingle Rakesh Garg
Mridu Paban Nath
Sanjay Verma
Ashwani Kumar
Patient with von Willebrand Disease for Gynaecologic Surgery - Perianaesthetic Concerns
Indian Journal of Anaesthesia
von Willebrand disease
von Willebrand factor
Coagulopathy.
title Patient with von Willebrand Disease for Gynaecologic Surgery - Perianaesthetic Concerns
title_full Patient with von Willebrand Disease for Gynaecologic Surgery - Perianaesthetic Concerns
title_fullStr Patient with von Willebrand Disease for Gynaecologic Surgery - Perianaesthetic Concerns
title_full_unstemmed Patient with von Willebrand Disease for Gynaecologic Surgery - Perianaesthetic Concerns
title_short Patient with von Willebrand Disease for Gynaecologic Surgery - Perianaesthetic Concerns
title_sort patient with von willebrand disease for gynaecologic surgery perianaesthetic concerns
topic von Willebrand disease
von Willebrand factor
Coagulopathy.
url http://www.ijaweb.org/article.asp?issn=0019-5049;year=2008;volume=52;issue=5;spage=573;epage=573;aulast=Garg
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