Considerations for epidural anesthesia in a patient with type 1 von Willebrand disease

November 2009
Journal of Anesthesia;2009, Vol. 23 Issue 4, p597
Academic Journal
Epidural anesthesia, combined with general anesthesia, was performed in a patient with type 1 von Willebrand disease (VWD). VWD is a common inherited bleeding disorder, and an anesthetic concern in patients with VWD is susceptibility to postoperative bleeding and epidural or spinal hematoma associated with neuraxial block. After confirming the patient�s responsiveness to 1-desamino-8-D-arginine vasopressin (DDAVP) and obtaining informed consent, epidural anesthesia was performed to avoid the use of analgesics that inhibit platelet function. The patient�s postoperative course was uneventful. Epidural anesthesia could be one of the choices of treatment for postoperative pain in those patients with type 1 VWD for whom the conditions discussed are fulfilled, to ensure safe usage of this technique.


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