[Anesthetic management of the cesarean section in a patient with aplastic anemia].
A 31-year-old woman with aplastic anemia was admitted for the management of delivery at 33 weeks of gestation. Platelet count was 2.3 x 10(4) x microl(-1) on admission. Corticosteroid therapy after admission was not effective, and we decided to manage the delivery with elective cesarean section after platelet transfusion. After forty units of platelet transfusion, platelet count was 8.1 x 10(4) x microl(-1), and we decided to perform cesarean section under spinal anesthesia. Spinal anesthesia was given using a 25-gauge Quincke needle at L3-4 interspace, and 0.5% hyperbaric bupivacaine 2.5 ml with 0.15 mg morphine was injected. Block level was confirmed as T8 by a pinprick method. Blood loss during operation was 858 g, and complications were not seen during operation. In the case of delivery with uncontrolled aplastic anemia, elective cesarean section is thought to be safe. If platelet count is over 5.0 x 10(4) x microl(-1) after platelet transfusion, spinal anesthesia should be used.
Kotera
Atsushi
A
Department of Anesthesiology, National Kumamoto Medical Center, Kumamoto 860-0008.
Miyazaki
Naoki
N
Hashimoto
Masahiro
M
Kouzuma
Seiji
S
Taki
Kenichiro
K
Esaki
Kimiaki
K
D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications*; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D002045:Bupivacaine; D002585:Cesarean Section; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D009020:Morphine; D019990:Perioperative Care; D017713:Platelet Transfusion; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic
D009020:Morphine; D002045:Bupivacaine