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Neuraxial Anesthesia in Severe Hemophilia A Using Extended Half-Life Factor VIII (Efanesoctocog Alfa): A Case Report
Aby Dixon Pynadath1,2, Aleyna Grace Brunner1,2
1From the Department of Anesthesiology, University of Illinois College of Medicine, Peoria, Illinois.
Abstract:
Hemophilia A presents significant perioperative challenges, particularly for neuraxial anesthesia due to the risk of spinal or epidural hematoma. Extended half-life recombinant factor VIII products (EHL), such as efanesoctocog alfa, provide sustained FVIII activity. We report a 52-year-old man with severe hemophilia A on weekly EHL prophylaxis undergoing total knee arthroplasty under spinal anesthesia with an adductor canal block. FVIII levels were maintained with a combination of EHL and standard factor VIII replacement. The patient had no neurologic sequelae. Safe neuraxial anesthesia can be achieved in hemophilia A with a combination of EHL and standard factor VIII replacement.
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