Peri‐operative management of a patient with hereditary angioedema undergoing laparoscopic cholecystectomy

Spyridonidou, A; Iatrou, Christos; Alexoudis, A; Vogiatzaki, Theodosia; Polychronidis, Alexandros; Simopoulos, Constantinos

doi:10.1111/j.1365-2044.2009.06130.x

Cited by 12 publications

(6 citation statements)

References 36 publications

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“…No angioedema occurred, irrespective of the duration of the procedure. 71 In five additional case-series studies (n ϭ 10), 30,33,34,36,72 and 21 case reports, 42,44,45,47,58,63,[73][74][75][76][77][78][79][80][81][82][83][84][85][86][87] there were no cases of angioedema after administration of C1-INH as short-term prophylaxis. …”

Section: Preprocedural Short-term Prophylaxis With C1-inhmentioning

confidence: 99%

Treatment with C1-esterase inhibitor concentrate in type I or II hereditary angioedema: A systematic literature review

Bork

Steffensen²,

Machnig³

2013

allergy asthma proc

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Hereditary angioedema (HAE) due to C1 esterase inhibitor (HAE-C1-INH) deficiency is a rare genetic disorder presenting with recurrent episodes of skin swellings, abdominal pain attacks, and potentially fatal laryngeal edema. This study was designed to review the efficacy and safety of pasteurized, human, plasma-derived C1-INH concentrate for the treatment of patients with HAE-C1-INH. A systematic search of electronic databases up to December 2011 was performed without language or date restrictions. Two reviewers completed the study selection using predefined inclusion criteria, tabulated, and analyzed the data. The data were inappropriate for meta-analysis; thus, a qualitative synthesis was performed. We identified 89 studies (≍2000 patients) that investigated C1-INH. Replacement therapy with C1-INH significantly shortened time to onset of symptom relief in HAE attacks compared with placebo in a randomized controlled trial, and similar improvements were consistently reported in observational and descriptive studies, accompanied by improvements in patients' quality of life. C1-INH has been shown to be effective for patients receiving home therapy and short- and long-term prophylaxis. Treatment with C1-INH was generally well tolerated. Administration of C1-INH was not associated with transmission of viruses or development of autoantibodies irrespective of treatment duration. This research provides additional confirmation of the efficacy of C1-INH in the treatment and prevention of HAE attacks. C1-INH is generally safe and well tolerated and has an excellent safety record for over 25 years of clinical use.

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Section: Preprocedural Short-term Prophylaxis With C1-inhmentioning

confidence: 99%

Treatment with C1-esterase inhibitor concentrate in type I or II hereditary angioedema: A systematic literature review

Bork

Steffensen²,

Machnig³

2013

allergy asthma proc

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“…Airway edema in HAE cannot be predicted by the frequency of or intervals between attacks [17] and, as such, pharmacological prophylaxis is desirable [18]. In accordance with the established World Allergy Organization guideline [19], we administered 1500 U of C1-esterase inhibitor, which was prepared in the operating room for additional use, in addition to danazol and tranexamic acid, preoperatively.…”

Section: Discussionmentioning

confidence: 99%

Successful anesthetic management during abdominal wall-lifting laparoscopic cholecystectomy in a patient with hereditary angioedema

et al. 2018

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Background: Hereditary angioedema is a rare genetic disorder resulting from an inherited deficiency or dysfunction of the C1-esterase inhibitor. In the anesthetic management of such patients, special caution should be exercised while attempting tracheal intubation because it may cause mucosal edema in the upper airway. Case presentation: A 52-year-old female with hereditary angioedema was scheduled for laparoscopic cholecystectomy. C1-esterase inhibitor, Danazol, tranexamic acid, and prednisolone were administered on the day of surgery. An epidural catheter was inserted through the intervertebral space at T9/10, and spinal anesthesia was instilled via the L3/4 intervertebral space. A single-hole, Nishii-type lifting laparoscopic surgery, without pneumoperitoneum (i.e., gasless) was completed uneventfully. Conclusion: This report described the successful management of a patient with hereditary angioedema who underwent laparoscopic cholecystectomy using spinal-epidural anesthesia without tracheal intubation and lift type laparoscopic surgery. This approach to anesthetic management could be indicated in cases with a similar presentation.

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“… 35 Dental surgery, even if considered minor surgery, may be associated with swelling of the oral cavity that can progress and cause airway constriction, which can be life threatening. 1 , 12 , 31 , 33 , 36 Currently, short-term prophylaxis, typically with danazol or C1-INH, is indicated for HAE patients before major medical, surgical, or dental procedures. 7 , 9 There are currently no universal guidelines regarding perioperative management of a patient with HAE; however, recommendations of administration of C1-INH before procedures, starting or increasing doses of attenuated androgens and administering fresh frozen plasma (FFP), have been recommended ( Table 1 ).…”

Section: Perioperative Managementmentioning

confidence: 99%

Perioperative Management for Patients with Hereditary Angioedema

Williams

Craig

2015

Allergy�Rhinol (Providence)

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Hereditary angioedema (HAE) is a rare autosomal dominant disease that results from mutations in the C1-esterase inhibitor (C1-INH) gene. HAE is characterized by recurrent episodes of angioedema of the skin (face, extremities, genitalia, trunk), the gastrointestinal tract, and respiratory tract. Symptoms experienced can be debilitating, may impact quality of life, and can be life threatening. Preventing attacks particularly for patients undergoing procedures is critical. Patients with HAE may now treat acute attacks or prevent attacks with medications that have recently become available in the United States; however, these same medications can be used for perioperative management for patients undergoing medical, surgical, and dental procedures. Periprocedural planning is important for patients to reduce the incidence of acute attacks. Education is critical and increasing awareness of short-term prophylaxis options will allow providers to develop an appropriate action plan for their patients. The goal of this review is to increase awareness for HAE treating physicians, surgeons, anesthesia, and emergency room physicians by examining the available treatment options, researching the literature, and summarizing available data for periprocedural management. The availability of treatment options has increased over the past few years, expanding options for physicians and patients living with HAE and improve safety during the perioperative period and at the time of other procedures.

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Peri‐operative management of a patient with hereditary angioedema undergoing laparoscopic cholecystectomy

Cited by 12 publications

References 36 publications

Treatment with C1-esterase inhibitor concentrate in type I or II hereditary angioedema: A systematic literature review

Treatment with C1-esterase inhibitor concentrate in type I or II hereditary angioedema: A systematic literature review

Successful anesthetic management during abdominal wall-lifting laparoscopic cholecystectomy in a patient with hereditary angioedema

Perioperative Management for Patients with Hereditary Angioedema

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