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[Anesthesia for a patient with severe aplastic anemia]
M Tanaka1, I Nishihara, H Mori
1Department of Anesthesiology, Osaka Medical College, Takatsuki.
A 48-year-old female with severe aplastic anemia was scheduled for transurethral lithotomy because of pyelonephritis and urethral stone. Laboratory studies showed anemia (168 x 10(4).mm-3), leukopenia (2300.mm-3) and thrombocytopenia (5000.mm-3). Bleeding time exceeded 30 min, but the transfusion of fresh platelet concentrate was not effective for bleeding tendency. Anesthesia was induced with midazolam 0.5 mg and fentanyl 100 micrograms, and maintained with N2O-O2-sevoflurane through a mask. The operation, which lasted for 40 min, was uneventful without marked hemodynamic changes, bucking or massive bleeding. Although 100 units of fresh platelet and 13 units of leucocyte poor red cells were infused during hospitalization, macrohematuria continued for about 3 weeks after this operation.
A 48-year-old female with severe aplastic anemia was scheduled for transurethral lithotomy because of pyelonephritis and urethral stone. Laboratory studies showed anemia (168 x 10(4).mm-3), leukopenia (2300.mm-3) and thrombocytopenia (5000.mm-3). Bleeding time exceeded 30 min, but the transfusion of fresh platelet concentrate was not effective for bleeding tendency. Anesthesia was induced with midazolam 0.5 mg and fentanyl 100 micrograms, and maintained with N2O-O2-sevoflurane through a mask. The operation, which lasted for 40 min, was uneventful without marked hemodynamic changes, bucking or massive bleeding. Although 100 units of fresh platelet and 13 units of leucocyte poor red cells were infused during hospitalization, macrohematuria continued for about 3 weeks after this operation.