Wound analgesia in a patient with hemophilia in a highly traumatic operation

Abstract

Given a number of limitations on the use of perioperative analgesia in patients with hemophilia, wound analgesia may be one of the components of multimodal analgesia in this category of patients. The aim of the study was to describe the use of the wound analgesia method in a patient with hemophilia in the case of a clinical case. Materials and methods. A patient with severe hemophilia A underwent postoperative analgesia after total knee replacement (within the first 48 hours) with an extended infusion of local anesthetic (ropivacaine) into the wound. Results. During the first 8 hours, the patient received 20 mg of morphine (with the aid of a device for patient-controlled analgesia), the pain level ranged from 7 to 4 points. Further, there was a sufficient effect (NRS - 2 points), from anesthesia only with ropivacaine, using a system for anesthetizing surgical wounds. Complications and side effects were not noted. Conclusion. The clinical case demonstrates an effective and safe method of prolonged analgesia in patients with hemophilia. Considering encouraging data, further study of wound analgesia in this category of patients is necessary.