Anaesthetic management of parturient with malaria and thrombocytopaenia

Khanna, Ashish; Dua, Naresh; Sehgal, Raminder; Sood, Jayashree

doi:10.4103/0019-5049.183386

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…Intraoperative measures include maintenance of intraoperative cardiac output, pneumatic stockings to prevent peripheral stagnation of blood, use of dextran, and early ambulation in the postoperative period [1,7]. Peribulbar block when used as an adjunct to general anesthesia was a safe and useful analgesic technique for pediatric ophthalmic surgery [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism of hypoglycemia is due to increase in methionine level which stimulates the pancreatic cell to release more insulin. Hypoglycemia may be prevented by restricting pre-operative fasting to the acceptable minimum, administration of intravenous dextrose, and monitoring perioperative blood glucose [1]. We opted for safe outcome of the patient, it was an elective case, so medical management was started to reduce the serum homocysteine level lower value along with systemic anticoagulation and antiplatelet therapy to reduce the perioperative thromboembolic events.…”

Section: Discussionmentioning

confidence: 99%

“…Homocystinuria is an inborn error of transsulfuration metabolic pathway due to cystathionine-β-synthase deficiency. It is biochemically characterized by increased plasma homocysteine, methionine, and decreased cysteine [1,2]. Clinically, it manifests as multisystemic connective tissue disorder involving mainly muscles, central nervous, and cardiovascular systems.…”

Section: Introductionmentioning

confidence: 99%

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Anesthetic implications of homocystinuria: A case report

Upadhyay¹

2018

jaccr

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Introduction: Homocystinuria is an inherited metabolic disorder associated with cystathionine beta-synthase deficiency leading to accumulation of both methionine and homocysteine in various tive tissues and blood manifesting clinically as multisystem disorder. It is associated with a high incidence of thromboembolic complications and high mortality during the perioperative period. Homocystinuria imposed number of anesthetic challenges during the perioperative period. Case Report: A 10-year-old male presented with dimness of vision and was found to have ectopia lentis. Based on his clinical findings, he was suspected to have homocystinuria. This was confirmed by his high serum homocysteine levels. The child was posted for lensectomy with vitrectomy. The homocysteine and methionine level were brought down to the safer limit by monthlong medical and nutritional therapy before taking up for the surgery. The surgery was done under general anesthesia and peribulbar block. The perioperative measure included avoidance of prolonged fasting, avoidance of nitrous oxide, mechanical and chemical thromboprophylaxis, and early mobilization. The patient had an uneventful post-operative period. Conclusion: Understanding the perioperative hazards and complications of homocystinuria can be avoided with proper preparation of the patient, judicious use of anesthetic techniques. This case report described some of the anesthetic challenges during management of such a patient. Keywords: Homocystinuria, general anesthesia, thromboembolism, nitrous oxide.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anesthetic implications of homocystinuria: A case report

Upadhyay¹

2018

jaccr

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Infectious Diseases in Pregnancy

Smith,

Megli,

A. Chappell

2024

Obstetric Anesthesia and Uncommon Disorders

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Challenges and Strategies in Administering Anesthesia to Pregnant Patients With Malaria: A Comprehensive Review

Patond,

Bhalerao

2024

Cureus

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Malaria remains a significant global health challenge, particularly in sub-Saharan Africa, where its impact on pregnant women and their fetuses is profound. The disease's complex interaction with pregnancy introduces unique challenges in anesthesia management, necessitating a thorough understanding of both malaria and its implications for anesthetic care. This review aims to explore the multifaceted issues associated with anesthesia for pregnant patients with malaria, examining the impact of the disease on pregnancy and the specific considerations required for effective anesthetic management. A comprehensive review of the current literature was conducted, focusing on the physiological effects of malaria on pregnancy, its complications, and the related anesthetic challenges. The review synthesizes findings from clinical studies, case reports, and expert guidelines to provide an overview of best practices and strategies. Malaria in pregnant women can lead to severe complications such as maternal anemia, placental insufficiency, and preterm labor, all of which complicate anesthetic management. The review identifies key considerations for anesthesia, including the choice of anesthetic techniques, drug interactions, and fluid management. Specific challenges include managing anemia, ensuring adequate hemodynamic stability, and mitigating potential risks associated with malaria medications. Effective anesthesia management in pregnant patients with malaria requires a nuanced approach that addresses both the disease's effects and the physiological changes of pregnancy. This review underscores the need for tailored anesthetic strategies and highlights areas for further research to enhance patient safety and outcomes. Recommendations are provided to guide clinicians in optimizing care for this vulnerable population.

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Anaesthetic management of parturient with malaria and thrombocytopaenia

Cited by 3 publications

References 6 publications

Anesthetic implications of homocystinuria: A case report

Anesthetic implications of homocystinuria: A case report

Infectious Diseases in Pregnancy

Challenges and Strategies in Administering Anesthesia to Pregnant Patients With Malaria: A Comprehensive Review

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