Anesthesia for polycythemia vera

Sosis, Mitchel B.

doi:10.1016/0952-8180(90)90046-6

Cited by 9 publications

(14 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Notably, cerebral blood flow is typically decreased in PV due to hyperviscosity, and decreasing haematocrit to 46% or below increases it significantly [23]. Although this decreases arterial oxygen content, the resultant increased cerebral blood flow compensates for the fall in oxygen and can help reduce the risk of haemorrhage and thrombotic complications [24,25]. Furthermore, PV patients undergoing CABG surgery should have additional surveillance with haemodilution as a haematocrit under 22% may lead to postoperative complications, such as stroke, myocardial [27].…”

Section: Discussionmentioning

confidence: 99%

Polycythaemia Vera and Coronary Artery Bypass Graft Surgery: A Systematic Review of the Literature

Janmohamed

Sondh

Ahmed

et al. 2022

Heart, Lung and Circulation

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Polycythaemia Vera and Coronary Artery Bypass Graft Surgery: A Systematic Review of the Literature

Janmohamed

Sondh

Ahmed

et al. 2022

Heart, Lung and Circulation

View full text Add to dashboard Cite

“…In order to reduce blood viscosity, adequate hydration must be promoted, prolonged fasting periods avoided, and, if necessary, intravenous fluids administered. Many of these patients will be on antiplatelet therapy, and peri-operative management should be individualised to patient risk [1][2][3][4].…”

Section: Discussionmentioning

confidence: 99%

Spinal subarachnoid haematoma after neuraxial anaesthesia in a patient with polycythaemia vera

Martins

Montenegro

Silva

et al. 2021

Anaesthesia Reports

View full text Add to dashboard Cite

Polycythaemia vera is a common haematological proliferative disorder. It is characterised by uncontrolled red cell production with ensuing peri-operative vaso-occlusive and haemorrhagic complications. Spinal haematoma after neuraxial anaesthesia is rare; most cases are associated with technical difficulties or bleeding disorders. Current consensus opinion suggests that neuraxial anaesthesia in patients with polycythaemia vera is safe due to a lower risk of thrombotic events and hypoxaemia compared with general anaesthesia. We report a case of a spinal subarachnoid haematoma after uneventful neuraxial anaesthesia in a patient with optimised polycythaemia vera. Despite an emergent laminectomy, the patient developed permanent motor deficits. This report highlights that although neuraxial anaesthesia is recommended by many authors, patients with polycythaemia vera can paradoxically have an increased haemorrhagic risk from platelet dysfunction and acquired von Willebrand disease. Clinicians proceeding with surgery under neuraxial anaesthesia should appreciate these risks even in patients with normal or apparently elevated thrombotic states. This case also demonstrates that traditional coagulation tests may need to be complemented by pre-operative platelet function tests and screening for von Willebrand disease. Finally, the importance of the patient participation in the choice of the anaesthesia technique cannot be understated, with specific attention paid to this frequently unrecognised risk.

show abstract

“…Polycythemia vera also occurs so rarely that there is currently insufficient evidence to establish a standard anesthetic management strategy. However, a few reports regarding anesthetic management of polycythemia vera can be found [3,4], Fig. 1 Changes in hemoglobin and erythropoietin levels.…”

Section: Discussionmentioning

confidence: 99%

“…While some reports are available regarding the anesthetic management of polycythemia vera [3][4][5][6], to the best of our knowledge, there are no previous reports regarding the anesthetic management of erythropoietin-producing uterine myoma. Herein, we report the successful administration of general anesthesia to a patient with erythropoietin-producing uterine myoma.…”

Section: Introductionmentioning

confidence: 99%

Successful perioperative management of a patient with erythropoietin-producing uterine myoma

et al. 2018

View full text Add to dashboard Cite

Background: Erythropoietin-producing uterine myoma can cause various complications such as arterial or venous thrombosis and bleeding. Therefore, caution is required in the anesthetic management of affected patients. Case presentation: A 57-year-old female was suspected to have an erythropoietin-producing uterine myoma and was scheduled to undergo an abdominal total hysterectomy and bilateral salpingo-oophorectomy. Preoperative levels of hemoglobin and erythropoietin were 21.9 g/dl (normal 11.5-15 g/dl) and 23.2 IU/ml (normal 4.2-23.7 IU/ ml), respectively. Preoperative phlebotomy and isovolemic hemodilution were performed to prevent arterial and venous thrombosis, following previous evidence that a hemoglobin level < 16 g/dl reduces the occurrence of polycythemia vera-related complications. Fondaparinux 2.5 mg was subcutaneously injected once daily after the operation, resulting in a good perioperative course without major complications. Conclusion: Herein, we have described a successful perioperative management of a patient with erythropoietinproducing uterine myoma. Our findings in this case suggest that this combination of antithrombotic therapies can facilitate anesthetic management of patients with this disease.

show abstract

Anesthesia for polycythemia vera

Cited by 9 publications

References 19 publications

Polycythaemia Vera and Coronary Artery Bypass Graft Surgery: A Systematic Review of the Literature

Polycythaemia Vera and Coronary Artery Bypass Graft Surgery: A Systematic Review of the Literature

Spinal subarachnoid haematoma after neuraxial anaesthesia in a patient with polycythaemia vera

Successful perioperative management of a patient with erythropoietin-producing uterine myoma

Contact Info

Product

Resources

About