Anesthetic Management of an Adolescent with Hypofibrinogenemia Posted for Cervical Deformity Correction!

A 15-year-old boy diagnosed as case of cervical kyphosis, atlantoaxial dislocation, and hypofibrinogenemia was posted for corrective surgery under general anesthesia. His preoperative plasma fibrinogen levels and other coagulation profile were deranged. He was diagnosed with type 1 congenital fibrinogen abnormality, that is, hypofibrinogenemia. Preoperative blood products including cryoprecipitates were transfused to correct fibrinogen levels and coagulation profile. Cryoprecipitate was transfused at the dose of 1 bag per 10kg body weight per day. During intraoperative period, blood products were transfused following blood loss of 1100mL. Postoperatively the repeat laboratory investigations after 20 h revealed normal PF levels (211 mg/dL) with normal coagulation profile. He was discharged five days later with the uncomplicated postoperative course.