[Anesthetic management for hip joint fracture surgery in an elderly patient with untreated polycythemia vera]

The author report anesthetic management of an elderly patient with untreated polycythemia vera undergoing hip joint fracture surgery. Hydroxycarbamide was administered for erythrocytosis and thrombocytosis before surgery. Antithrombotic treatment with warfarin, aspirin and physical therapy, was continued during perioperative period. Surgery was performed under general anesthesia with hematocrit below 50% and platelet below 500 thousand x microl(-1). Hypovolemia was avoided to prevent hemoconcentration. No complication occurred perioperatively, although a high proportion of patients with polycythemia vera are complicated with vascular occlusion and major hemorrhage.