Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942004000600017
Brazilian Journal of Anesthesiology
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

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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

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