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Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease
Joint Authors
DiStefano, Youmna E.
Lazar, Michael D.
Source
Case Reports in Anesthesiology
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-05-31
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Peripheral nerve blockade (PNB) is superior to neuraxial anesthesia and/or opioid therapy for perioperative analgesia in total knee replacement (TKR).
Evidence on the safety of PNB in patients with coagulopathy is lacking.
We describe the first documented account of continuous femoral PNB for perioperative analgesia in a patient with Von Willebrand Disease (vWD).
Given her history of opioid tolerance and after an informative discussion, a continuous femoral PNB was planned for in this 34-year-old female undergoing TKR.
A Humate-P intravenous infusion was started and the patient was positioned supinely.
Using sterile technique with ultrasound guidance, a Contiplex 18 Gauge Tuohy needle was advanced in plane through the fascia iliaca towards the femoral nerve.
A nerve catheter was threaded through the needle and secured without complications.
Postoperatively, a levobupivacaine femoral catheter infusion was maintained, and twice daily Humate-P intravenous infusions were administered for 48 hours; enoxaparin thromboprophylaxis was initiated thereafter.
The patient was discharged uneventfully on postoperative day 4.
Given documentation of delayed, unheralded bleeding from PNB in coagulopathic patients, we recommend individualized PNB in vWD patients.
Multidisciplinary team involvement is required to guide factor supplementation and thromboprophylaxis, as is close follow-up to elicit signs of bleeding throughout the delayed postoperative period.
American Psychological Association (APA)
DiStefano, Youmna E.& Lazar, Michael D.. 2015. Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease. Case Reports in Anesthesiology،Vol. 2015, no. 2015, pp.1-4.
https://search.emarefa.net/detail/BIM-1058056
Modern Language Association (MLA)
DiStefano, Youmna E.& Lazar, Michael D.. Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease. Case Reports in Anesthesiology No. 2015 (2015), pp.1-4.
https://search.emarefa.net/detail/BIM-1058056
American Medical Association (AMA)
DiStefano, Youmna E.& Lazar, Michael D.. Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease. Case Reports in Anesthesiology. 2015. Vol. 2015, no. 2015, pp.1-4.
https://search.emarefa.net/detail/BIM-1058056
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1058056