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Ozdemir, haluk (2011)
Publisher: Dove Press
Journal: Local and Regional Anesthesia
Languages: English
Types: Report
Subjects: Local and Regional Anesthesia, factor V Leiden, pain, regional anesthesia, vein harvest, Case Report
Kerem Erkalp1, Mevlut Comlekci1, Bekir Inan2, Gokcen Basaranoglu1, Haluk Ozdemir1, Leyla Saidoglu11Department of Anaesthesiology and Reanimation, Vakif Gureba Hospital, Istanbul, Turkey; 2Department of Vascular Surgery, Vakif Gureba Hospital, Istanbul, TurkeyAbstract: Anesthetic management of patients with coagulation disorders presents safety and technical challenges. This case describes a 58-year-old woman with factor V Leiden mutation who required distal saphenous vein harvest and axillo-brachial bypass to treat axillary artery occlusion. The patient underwent surgery with satisfactory anesthesia using infraclavicular brachial plexus block, thoracic paravertebral block, and unilateral subarachnoid block. These three regional anesthetic interventions were performed in lieu of general anesthesia to minimize risks of thrombotic events, pain, and to decrease recovery time. Despite higher failure rates of regional anesthesia, longer time required for procedures, and added discomforts during surgery, the benefits may outweigh risks for selected high-risk patients, including those with factor V Leiden mutations.Keywords: regional anesthesia, factor V Leiden, pain, vein harvest
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Basagan-Mogol E, Turker G, Yilmaz M, et al. Combination of a psoas compartment, sciatic nerve, and T12-L1 paravertebral blocks for femoropopliteal bypass surgery in a high-risk patient. J Cardiothorac Vasc Anesth. 2008;22:337-339.
    • 2. Harnett MJ, Walsh ME, McElrath TF, et al. The use of central neuraxial techniques in parturients with factor V Leiden mutation. Anesth Analg. 2005;101:1821-1823.
    • 3. Eason MJ, Wyatt R. Paravertebral thoracic block-a reappraisal. Anaesthesia. 1979;34:638-642.
    • 4. Comlekci M, Basaranoglu G, Suren M, et al. An approach to infraclavicular brachial plexus block: the highest point of the shoulder as a reference. Anesth Analg. 2006;103:1634-1635.
    • 5. Curigliano G, MandalĂ  M, Sbanotto A, et al. Factor V leiden mutation in patients with breast cancer with a central venous catheter: risk of deep vein thrombosis. Support Cancer Ther. 2006;3:98-102.
    • 6. Cooley BC, Chen CY, Schmeling G. Increased venous versus arterial thrombosis in the Factor V Leiden mouse. Thromb Res. 2007;119: 747-751.
    • 7. Hollmann MW, Wieczorek KS, Smart M, et al. Epidural anesthesia prevents hypercoagulation in patients undergoing major orthopedic surgery. Reg Anesth Pain Med. 2001;26:215-222.
    • 8. Cooter RD, Rudkin GE, Gardiner SE. Day case breast augmentation under paravertebral blockade: a prospective study of 100 consecutive patients. Aesthetic Plast Surg. 2007;31:666-673.
    • 10. Valanne JV, Korhonen AM, Jokela RM, et al. Selective spinal anesthesia: a comparison of hyperbaric bupivacaine 4 mg versus 6 mg for outpatient knee arthroscopy. Anesth Analg. 2001;93:1377-1379.
    • 11. Horlocker TT, Wedel DJ, Benzon H, et al. Regional anesthesia in the Pain Med. 2003;28:172-197.
    • 9. Karmakar MK. Thoracic paravertebral block. Anesthesiology. 2001;95: 12. Albani A, Renghi A, Gramaglia L, et al. Regional anaesthesia in and postoperative discharge. Minerva Anestesiol. 2001;67:151-154.
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  • Discovered through pilot similarity algorithms. Send us your feedback.

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