Central neuraxial blockade in chronic immune thrombocytopenic purpura: Platelet count or function and the concept of rebalanced hemostasis
Anesthetic management of patients having immune thrombocytopenic purpura (ITP) remains a challenge for the anesthesiologist. Surgeries such as knee arthroplasty are associated with significant bleeding. Neuraxial anesthesia is often preferred for knee arthroplasty. However, in patients with bleeding...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | The Indian Anaesthetists' Forum |
| Subjects: | |
| Online Access: | http://www.theiaforum.org/article.asp?issn=0973-0311;year=2016;volume=17;issue=2;spage=48;epage=51;aulast=Dhansura |
| _version_ | 1818196818477973504 |
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| author | Tasneem Dhansura Nabila Shaikh Tarana Shaikh Mohtasib Madaoo |
| author_facet | Tasneem Dhansura Nabila Shaikh Tarana Shaikh Mohtasib Madaoo |
| author_sort | Tasneem Dhansura |
| collection | DOAJ |
| description | Anesthetic management of patients having immune thrombocytopenic purpura (ITP) remains a challenge for the anesthesiologist. Surgeries such as knee arthroplasty are associated with significant bleeding. Neuraxial anesthesia is often preferred for knee arthroplasty. However, in patients with bleeding diathesis such as ITP, neuraxial anesthetic management remains controversial as there are no specific guidelines, and there is a risk of spinal hematoma. There are numerous case reports of safe regional anesthesia administered in parturients suffering from thrombocytopenia, but no explanation has been given. A new emerging concept of "rebalanced hemostasis" is now being used to explain the discrepancies observed in the laboratory reports versus the actual bleeding. In our case report, we have reviewed the literature and described the anesthetic management of a patient having chronic ITP and chronic obstructive pulmonary disease undergoing knee arthroplasty under neuraxial technique. |
| first_indexed | 2024-12-12T01:40:07Z |
| format | Article |
| id | doaj.art-99f58a69b12c477b9db17c2e79ed3961 |
| institution | Directory Open Access Journal |
| issn | 0973-0311 0973-0311 |
| language | English |
| last_indexed | 2024-12-12T01:40:07Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Indian Anaesthetists' Forum |
| spelling | doaj.art-99f58a69b12c477b9db17c2e79ed39612022-12-22T00:42:45ZengWolters Kluwer Medknow PublicationsThe Indian Anaesthetists' Forum0973-03110973-03112016-01-01172485110.4103/0973-0311.195961Central neuraxial blockade in chronic immune thrombocytopenic purpura: Platelet count or function and the concept of rebalanced hemostasisTasneem DhansuraNabila ShaikhTarana ShaikhMohtasib MadaooAnesthetic management of patients having immune thrombocytopenic purpura (ITP) remains a challenge for the anesthesiologist. Surgeries such as knee arthroplasty are associated with significant bleeding. Neuraxial anesthesia is often preferred for knee arthroplasty. However, in patients with bleeding diathesis such as ITP, neuraxial anesthetic management remains controversial as there are no specific guidelines, and there is a risk of spinal hematoma. There are numerous case reports of safe regional anesthesia administered in parturients suffering from thrombocytopenia, but no explanation has been given. A new emerging concept of "rebalanced hemostasis" is now being used to explain the discrepancies observed in the laboratory reports versus the actual bleeding. In our case report, we have reviewed the literature and described the anesthetic management of a patient having chronic ITP and chronic obstructive pulmonary disease undergoing knee arthroplasty under neuraxial technique.http://www.theiaforum.org/article.asp?issn=0973-0311;year=2016;volume=17;issue=2;spage=48;epage=51;aulast=DhansuraBleeding diathesiscentral neuraxial blockadechronic immune thrombocytopenic purpuraepidural hematomarebalanced hemostasis |
| spellingShingle | Tasneem Dhansura Nabila Shaikh Tarana Shaikh Mohtasib Madaoo Central neuraxial blockade in chronic immune thrombocytopenic purpura: Platelet count or function and the concept of rebalanced hemostasis The Indian Anaesthetists' Forum Bleeding diathesis central neuraxial blockade chronic immune thrombocytopenic purpura epidural hematoma rebalanced hemostasis |
| title | Central neuraxial blockade in chronic immune thrombocytopenic purpura: Platelet count or function and the concept of rebalanced hemostasis |
| title_full | Central neuraxial blockade in chronic immune thrombocytopenic purpura: Platelet count or function and the concept of rebalanced hemostasis |
| title_fullStr | Central neuraxial blockade in chronic immune thrombocytopenic purpura: Platelet count or function and the concept of rebalanced hemostasis |
| title_full_unstemmed | Central neuraxial blockade in chronic immune thrombocytopenic purpura: Platelet count or function and the concept of rebalanced hemostasis |
| title_short | Central neuraxial blockade in chronic immune thrombocytopenic purpura: Platelet count or function and the concept of rebalanced hemostasis |
| title_sort | central neuraxial blockade in chronic immune thrombocytopenic purpura platelet count or function and the concept of rebalanced hemostasis |
| topic | Bleeding diathesis central neuraxial blockade chronic immune thrombocytopenic purpura epidural hematoma rebalanced hemostasis |
| url | http://www.theiaforum.org/article.asp?issn=0973-0311;year=2016;volume=17;issue=2;spage=48;epage=51;aulast=Dhansura |
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