A conundrum: general or neuraxial anesthesia and the use of ROTEM

作者：Mauritz A A^*; Strouch Z Y; Olufolabi A J

来源：Journal of Clinical Anesthesia, 2016, 32: 159-161.

DOI：10.1016/j.jclinane.2016.03.002

• Thrombocytopenia
• ROTEM
• Rotational thromboelastometry
• Spinal
• Pregnancy
• Platelets

We report the use of rotational thromboelastometry (ROTEM) to guide the management of a 29 year-old primigravida at 36 weeks' gestation with portal hypertension, esophageal varices, suspected pseudocholinesterase deficiency, and steroid refractory thrombocytopenia presenting to labor and delivery with worsening peripheral edema and new-onset hypertension. A multidisciplinary decision for preoperative platelet transfusion and cesarean delivery under spinal anesthesia was made, guided by ROTEM. A successful cesarean delivery was performed with no bleeding complications.

• 出版日期2016-8