RESUMO
Type 2B von Willebrand disease (vWD) is an inherited bleeding syndrome resulting from a qualitative abnormality of von Willebrand Factor with an increased affinity for the glycoprotein Ib platelet receptor. Pregnancy increases the severity of this disease by decreasing the platelet count restricting epidural anaesthesia because of adverse risk of spinal bleeding. There is a phenotypic variability of Type 2B vWD depending of the von Willebrand Factor mutation. We report here the strategy we used to administer epidural anaesthesia for a patient with Type 2B vWD resulting from the P1337L mutation of von Willebrand Factor.
Assuntos
Analgesia Epidural , Analgesia Obstétrica , Doença de von Willebrand Tipo 2/complicações , Analgesia Epidural/efeitos adversos , Analgesia Obstétrica/efeitos adversos , Contraindicações , Feminino , Hematoma Epidural Espinal/prevenção & controle , Humanos , Recém-Nascido , Mutação , Contagem de Plaquetas , Hemorragia Pós-Operatória/tratamento farmacológico , Gravidez , Adulto Jovem , Doença de von Willebrand Tipo 2/genética , Fator de von Willebrand/genéticaRESUMO
BACKGROUND: The i-gel is a new single-use supraglottic airway device with a noninflatable cuff and an esophageal vent. METHOD: In this prospective, observational study, we evaluated the i-gel in 71 women. RESULTS: Insertion success rate was 97%. Insertion was easy and performed at the first attempt in every patient. Mean seal pressure was 30 +/- 7 cm H(2)O, and average peak pressure was 11 +/- 3 cm H(2)O. The gastric tube was inserted in 100% of cases. Only one case of coughing and one mild sore throat occurred. CONCLUSION: The i-gel is a reliable, easily inserted airway device that provides an adequate seal with a low morbidity rate.
