General anesthesia with nerve blocks for a patient with femoral fracture and essential thrombocythemia: a case report

Abstract

Essential thrombocythemia (ET) is a type of myeloproliferative neoplasm characterized by an abnormal increase in platelets. We report a female patient with a severe femoral fracture and ET who underwent the femoral intramedullary fracture fixation procedure. Her past medical history included hypertension and ET. On the second day of hospitalization, her platelet count was 922 × 10⁹/L. In our case, general anesthesia combined with a femoral nerve block and a lateral femoral cutaneous nerve block were used when the platelet count was within normal range. After surgery, the platelet count increased to 979 × 10⁹/L despite using anticoagulant drugs and hydroxyurea. The postoperative recovery went well after the follow-up of this patient. In this case report, we provide our experience of anesthesia management and review the progress of relevant literature to provide some reference.

Keywords: Essential thrombocythemia; femoral fracture; general anesthesia; nerve block; perioperative management; platelet count.

Figure 1.

Perioperative X-ray of the femur. The photographs show the femoral fracture healing process.