title: [Anesthetic management of laparoscopic colon surgery in a patient with paroxysmal nocturnal hemoglobinuria].
abstract: This is a report of a patient with paroxysmal nocturnal hemoglobinuria (PNH) undergoing laparoscopic colon surgery. Preoperative examination showed pancytopenia, paroxysmal atrial fibrillation and slight renal function disorder. Heparin calcium was used to prevent venous thrombosis, because this case had several risk factors; advanced age, major surgery for cancer, PNH and long term medication with steroid. Washed red blood cells were transfused preoperatively. During the operation, total intravenous anesthesia was used. We prevented acidosis and other factors of thrombosis, and transfused washed red blood cells to correct anemia. During the postoperative course, red blood cells transfusion was required, but this case showed no obvious hemolysis, bleeding or venous thrombosis.
authors.affiliation: Department of Anesthesiology, Osaka Medical College, Takatsuki 569-8686.
authors.forename: Junko
authors.initials: J
authors.lastname: Nakahira
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sawai
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Minami
mesh_terms: D000138:Acidosis / Q000517:prevention & control; D000368:Aged; D000740:Anemia / Q000517:prevention & control; D000771:Anesthesia, Intravenous; D003082:Colectomy; D017707:Erythrocyte Transfusion; D006457:Hemoglobinuria, Paroxysmal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D019990:Perioperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D012307:Risk Factors; D013927:Thrombosis / Q000517:prevention & control