title: Anesthetic management of patient with systemic lupus erythematosus and thrombocytopenia for vaginal hysterectomy.
abstract: We report a case of a female having systemic lupus erythematosus, who was on steroid therapy and was scheduled for vaginal hysterectomy. She presented with breathlessness on mild exertion, a characteristic facial malar rash, and a platelet count 56,000 cells/cu mm. The patient was given a subarachnoid block with 2.8 ml 0.5% bupivacaine heavy in L3-L4 intervertebral space. Inj. Hydrocortisone 25 mg was given I.V. intraoperatively and repeated every 6 hours for 24 hours. Anesthetic management included considerations of systemic organ involvement, thrombocytopenia, and perioperative steroid replacement. Spinal block can be given with platelet count > 50,000/cumm. Strict asepsis should be maintained for invasive procedures. Maintenance of normothermia decreases the impact of Raynaud's phenomenon.
authors.affiliation: Department of Anaesthesia and Intensive Care, Safdarjang Hospital, New Delhi, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Chauhan
authors.affiliation: Department of Anaesthesia and Intensive Care, Safdarjang Hospital, New Delhi, India.
authors.forename: Kapil
authors.initials: K
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesia and Intensive Care, Safdarjang Hospital, New Delhi, India.
authors.forename: Chandni
authors.initials: C
authors.lastname: Kashyap
authors.affiliation: Department of Anaesthesia and Intensive Care, Safdarjang Hospital, New Delhi, India.
authors.forename: Pavan
authors.initials: P
authors.lastname: Nayar
keywords: Systemic lupus erythematosus; steroids; thrombocytopenia