title: [Anesthetic management of a patient with Evans syndrome--benefit of perioperative hemodilutional autologous blood transfusion].
abstract: The combination of idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia is termed Evans syndrome. We experienced the anesthetic management of a patient with this syndrome undergoing laparoscopic splenectomy. After induction of general anesthesia using thiamylal, fentanyl and vecuronium, hemodilutional autologous transfusion was employed to minimize the immune hemolytic process against the transfused blood throughout the surgical procedure. The anesthetic course was uneventful, and neither massive hemorrhage nor any complications related to bleeding occurred. We therefore recommend the use of hemodilutional autologous transfusion for the anteshetic management of patients with Evans syndrome.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Ashikawa Medical College, Asahikawa 078-8510.
authors.forename: Kohtaro
authors.initials: K
authors.lastname: Igarashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Sakurai
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahata
authors.forename: Tomoyo
authors.initials: T
authors.lastname: Saito
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakamaki
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Sengoku
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwasaki
mesh_terms: D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications; D000768:Anesthesia, General / Q000379:methods*; D001804:Blood Transfusion, Autologous; D006438:Hemodilution; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications; D013577:Syndrome