術前検査により特発性血小板減少性紫斑病と診断された患者に対してラリンジアルマスクを使用し全身麻酔下で智歯抜去術を行った1症例

抄録

  Idiopathic thrombocytopenic purpura (ITP) is an acquired autoimmune disease in which the number of platelets decreases without the involvement of an underlying disease or a drug that causes thrombocytopenia. We report a case in which a patient diagnosed as having Helicobacter pylori-related ITP underwent wisdom tooth removal while under general anesthesia performed using a laryngeal mask airway (LMA). The patient was a 54-year-old woman who was 155 cm tall and weighed 50 kg and had a history of hypertension. A preoperative blood test showed a platelet count of 25,000/μl. She was diagnosed as having H. pylori-related ITP in the Department of Internal Medicine and was treated with H. pylori eradication therapy. Since her platelet count recovered to 51,000/μl, we extracted a right mandibular wisdom tooth under general anesthesia performed using an LMA. No abnormal bleeding was observed during or after the operation, and the patient’s progress was good. Hemorrhage after invasive dental treatment is a concern in patients with low platelet counts. In patients with H. pylori-related ITP, the platelet count can be restored to normal by performing H. pylori eradication therapy. The use of an LMA can further reduce the risk of damage to the larynx and trachea and provide non-invasive anesthesia management. Here, we report a case in which the anesthesia management of a patient with H. pylori-related ITP could be safely performed in cooperation with a doctor.