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[Regional anaesthesia in haemophiliacs (author's transl)]
Abstract:
Since the middle of 1976 spinal and peridural anaesthesia are also being used for orthopaedic surgery of the lower extremities in haemophilic persons, the most important pre-requisites for the use of these techniques are: that it is a case of genuine haemophilia, that the deficiency is fully made up before and during anaesthesia and that the most important coagulation parameters are closely watched in co-operation with the Hemophilia Centre during the entire period. 46 haemophiliacs were given spinal and epidural anaesthesia via a catheter. A great advantage of these long-acting techniques is that less analgesics are needed during the postoperative period. Continuous peridural anaesthesia ensures freedom from pain without interfering with motoricity. The treatment of contractures of the joint by active and passive exercises has thus a better chance of success. Provided factors VIII/IX were kept normal there have so far not been any haemophilia-related haemorrhages into the spinal canal or cord or neurological disturbances that could be attributed to these anaesthetic techniques.