[Perioperative management of congenital antithrombin III deficiency]

Abstract

We describe perioperative management of a patient with congenital antithrombin III (ATIII) deficiency, who had an oral surgical operation under general anesthesia. The patient had a history of thrombosis. Preoperative plasma ATIII activity was 52% of the normal value. ATIII concentrates had been administered to prevent perioperative thrombosis. During the operation, the plasma ATIII level was maintained at 128%, and there was no episode of abnormal hemostasis. But, he complained of pain in his left leg probably due to thrombosis on the third day after operation, when his plasma ATIII activity was supposed to be approximately 70%. It is recommended that the plasma ATIII level is maintained, at least, above 80% for one week after the operation.