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Pediatric Anesthesia
Anesthesia and Pain Medicine 2010;5(3):260-263.
Published online July 31, 2010.
Anesthetic management of a patient with Kasabach-Merritt syndrome: A case report
Sung Chun Park, Ji Young Yoon, Jung Min Hong, Ji Uk Yoon, Gyeong Jo Byeon
Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea.
Kasabach-Merritt syndrome presents various problems for anesthetic management, which include thrombocytopenia, bleeding tendency, and problems arising from the hemangioma mass itself. A 1-month-old male was given sclerotherapies, platelet transfusions, steroid, interferon alpha, vincristine because of the bleeding from the right lower leg hemangioma, but platelet numbers were decreased and seizures occurred due to frontal lobe focal hemorrhage. After all, he was scheduled for his right lower leg amputation when he was 7 months old. Anesthesia was carefully induced with thiopental, rocuronium, fentanyl, and flexible bronchoscope. It was maintained with sevoflurane and air/oxygen with fentanyl injection. Although excessive bleeding was expected during anesthesia and surgery, the operation was performed without correction of platelet number. Two days later, postoperative course was improved almost normal.
Key Words: Anesthetic management, Kasabach-Merritt syndrome, Thrombocytopenia

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