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Hematological disorders:

Special Problems: Thalassemia:

It occurs in two forms. The primary defect is a slow rate of Hb synthesis. Special anesthesia problems: Idiopathic Thrombocytopenic Purpura:

In ITP, an antiplatelet factor is present which results in the excessive destruction of platelets by the spleen, with consequent thrombocytopenia and bleeding. The disease may be acute or chronic; the highest incidence is 7 years of age. The acute form, lasts for 1 month before spontaneous remission, may be complicated by severe intracranial bleeding or exsanguinating GI hemorrhage, but the overall death rate is less than 2%.

Surgical therapy: Splenectomy results in improvement in almost all the patients with acute ITP and many of those with the chronic condition.

Anesthetic problems: Hemophilia:

Factor VIII Deficiency (Classic Hemophilia Type A): Classic hemophilia is characterized by episodes of bleeding, either spontaneously or after minimal injury. Hemophilic children require special care during surgery.

Pre-operative measures: One hour before surgery, an infusion of cryoprecipitate (3mg/kg) should be given followed by an assay for plasma factor VIII activity. Surgery can proceed if factor VIII activity is over 30%.

Post-operative measures: Factor IX Deficiency (Christmas Disease, Hemophilia Type B):

Factor IX levels are assayed and factor IX infusions are given.

Also See "Frequently Asked Questions On Anesthesia"

Last created on 09-05-2001
Last submitted on 01-07-2006