Hemofilia e anestesia

Rafael Py Gonçalves Flores; Airton Bagatini; Ari Tadeu Lírio dos Santos; Cláudio Roberto Gomes; Mário Sérgio Fernandes; Roger Pelini Molon

doi:10.1590/S0034-70942004000600017

Miscellaneous

Hemofilia e anestesia

Hemophilia and anesthesia

Rafael Py Gonçalves Flores; Airton Bagatini; Ari Tadeu Lírio dos Santos; Cláudio Roberto Gomes; Mário Sérgio Fernandes; Roger Pelini Molon

http://dx.doi.org/10.1590/S0034-70942004000600017 Braz J Anesthesiol, vol.54, n6, p.865-871, 2004

PDF

Downloads: 8

Resumo

JUSTIFICATIVA E OBJETIVOS: Há mais de 25 anos não se discute, na Revista Brasileira de Anestesiologia, de maneira geral, o manuseio do paciente hemofílico durante o peri-operatório. Apesar da hemofilia ter sido definida como doença no início do século XIX, existem, até hoje, muitas descobertas relacionadas a ela. O objetivo dessa revisão é apontar os cuidados relacionados ao paciente hemofílico durante o período peri-operatório, ressaltando o manuseio da hemofilia tipo A e o papel do anestesiologista na equipe multidisciplinar. CONTEÚDO: Estão definidas as características da hemofilia quanto à clínica e aos achados laboratoriais, a terapia farmacológica atual e os cuidados com o manuseio do paciente hemofílico no intra-operatório. CONCLUSÕES: O manuseio do paciente hemofílico foi aprimorado. Como conseqüência desse avanço, percebe-se a importância e a necessidade de que novos conhecimentos, principalmente em relação à terapia de reposição, sejam dominados por hematologistas e por todo o corpo clínico-cirúrgico. Quando pacientes hemofílicos submetem-se a procedimentos cirúrgicos é necessário o envolvimento de uma equipe multidisciplinar da qual o anestesiologista faz parte. A este profissional cabe a responsabilidade de tomar as condutas mais adequadas frente ao paciente hemofílico, participando e comunicando-se ativamente com os membros da equipe multidisciplinar.

Palavras-chave

ANESTESIA, ANESTESIA

Abstract

BACKGROUND AND OBJECTIVES: For more than 25 years, there has been no discussion in the Brazilian Journal of Anesthesiology about hemophiliac patients' perioperative management. Hemophilia has been described as a disease from the early 19th Century, but still today there are many hemophilia-related breakthroughs. This review aimed at pointing hemophilia patient-related perioperative care, focusing on hemophilia A management and the role of the anesthesiologist as part of the multidisciplinary team. CONTENTS: Hemophilia features are described in terms of clinical and laboratory findings, current pharmacological therapy and intraoperative care of hemophilia patients. CONCLUSIONS: Hemophiliac patients management has improved. As a consequence of this advance, it is important that new knowledge, especially related to replacement therapy, be mastered not only by hematologists but also by the whole clinical-surgical team. A multidisciplinary team of which the anesthesiologist is part has to be involved when hemophilia patients are submitted to surgical procedures. The anesthesiologist should be in charge of adopting most adequate approaches for hemophilia patients, actively participating and communicating with the members of the multidisciplinary team.

Keywords

ANESTHESIA, ANESTHESIA

References

Boayue KB, Bell BA. Characteristics and management of bleeding in hemophilia and von Willebrand disease. Int J Pediat Hem Onc. 1994;1:449-461.

Ferreira AA, Cangiani LM, Vanetti LFA. Anestesia e o paciente hemofílico. Rev Bras Anestesiol. 1977;27:467-474.

Lusher JM, Warrier I. Hemophilia A. Hematol Oncol Clin North Am. 1992;6:1021-1033.

Hedner U, Glazer S. Management off hemophilia patients with inhibitors. Hematol Oncol Clin North Am.. 1992;6:1035-1046.

DiMichele D, Neufeld EJ. Hemophilia. A new approach to an old disease. Hematol Oncol Clin North Am. 1998;12:1315-1344.

Parmet JL, Horrow JC. Hematological Diseases. Anesthesia and Uncommon Diseases. 1998:299-301.

Guyton AC, Hall JE. Tratado de Fisiologia Médica. 1997:421-430.

Roizen MF. Anesthesia Implications of Concurrent Diseases. Anesthesia. 2000:903-1015.

Chaney JD, Nielsen VG. Considerations for the hemophiliac patient with inhibitors to factor VIII. Anesth Analg. 2001;92:785-786.

Martlew VJ. Perioperative management of patients with coagulation disorders. Br J Anaesth. 2000;85:446-455.

Hoyer LW. Hemophilia A. N Engl J Med. 1994;330:38-47.

Hemophilia Management. Transfusion Medicine Reviews. 1998;12(2):128-140.

Protocols for the Treatment of Hemophilia and von Willebrand Disease. Monograph Series. 1998.

Kang SB, Rumball KM, Ettinger RS. Continuous axillary brachial plexus analgesia in patient with severe hemophilia. J Clin Anesth. 2003;15:38-40.

Practice guidelines for blood component therapy: a report by the American Society of Anesthesiologists Task Force on blood component therapy. Anesthesiology. 1996;84:732-747.

Lethagen S. Desmopressin - a haemostatic drug: state-of-the-art review. . 1997;14:1-9.

Hemofilia e anestesia

Hemophilia and anesthesia

Rafael Py Gonçalves Flores; Airton Bagatini; Ari Tadeu Lírio dos Santos; Cláudio Roberto Gomes; Mário Sérgio Fernandes; Roger Pelini Molon

Resumo

Palavras-chave

Abstract

Keywords

References

Links

Share

Braz J Anesthesiol