초록접수[미리보기]

21KF-024
Spinal cord stimulator implantation in patient with hemophilia A: A Case Report
Joo Hyeon Oh1, Jee Youn Moon1,2, Yong Chul Kim1,2, Yong Jae Yoo1,2
Anesthesiology and Pain medicine, Seoul National University Hospital, Republic of Korea1, Anesthesiology and Pain medicine, Seoul National University College of Medicine, Republic of Korea2

Introduction

Spinal cord stimulation (SCS) has shown to be a safe and effective treatment in chronic pain management of neuropathic pain conditions, including Complex regional pain syndrome (CRPS). Even though there are rarely reports of epidural bleeding or hematoma caused by the implantation of SCS, SCS is classified as a high-risk procedure for bleeding, especially in patients with bleeding disorders.Hemophilia A is an blood coagulation disorder resulting from deficiency of coagulation factor VIII, and these patients need adequate laboratory support, careful hemostasis planning before invasive intervention.

Case report

A 39-year-old man with haemophilia A, who was diagnosed with CRPS type 1 visited our pain center for SCS implantation. The patient have been treated with several medications, including opioid analgesic drugs for persistent pain and multiple breakthrough pain, but had no significant improvement. Laboratory data was checked before and after surgery by consulting with a hematologist to supplement the Factor VIII. After confirming that the patient was satisfied during the stimulation trial period for about a week, permanent spinal cord stimulator implantation was done without any complications.

Conclusion

We underwent the implantation of SCS successfully for the patient with hemophilia A. Careful evaluation and optimization are needed before and after the procedure in patients with bleeding disorders.