Considerations for epidural anesthesia in a patient with type 1 von Willebrand disease.

Epidural anesthesia, combined with general anesthesia, was performed in a patient with type 1 von Willebrand disease (VWD). VWD is a common inherited bleeding disorder, and an anesthetic concern in patients with VWD is susceptibility to postoperative bleeding and epidural or spinal hematoma associated with neuraxial block. After confirming the patient's responsiveness to 1-desamino-8-D-arginine vasopressin (DDAVP) and obtaining informed consent, epidural anesthesia was performed to avoid the use of analgesics that inhibit platelet function. The patient's postoperative course was uneventful. Epidural anesthesia could be one of the choices of treatment for postoperative pain in those patients with type 1 VWD for whom the conditions discussed are fulfilled, to ensure safe usage of this technique.