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Anesthesia Experience for Tonsillectomy in a Patient With Hypofibrinogenemia

A Case Report

Aoki, Mariko, MD; Osaka, Yoshimune, MD, PhD; Ando, Kamon, MD, PhD; Morita, Yoshihisa, MD, PhD

doi: 10.1213/XAA.0000000000000903
Case Reports

A 26-year-old male patient with hypofibrinogenemia was scheduled to undergo tonsillectomy. Hypofibrinogenemia, defined as low plasma fibrinogen (Fbg) concentration, is a type of congenital Fbg deficiency and is a rare coagulopathy. Perioperative replenishment of Fbg is performed during minor surgeries, aimed at maintaining plasma Fbg concentrations of 50 mg/dL. In this case, failure to replenish Fbg during the postoperative period may have caused the postoperative hemorrhage. Considering the half-life of Fbg (3–4 days), the plasma Fbg concentration should be monitored for ≥6 postoperative days, aiming at a target level of 50 mg/dL during the postoperative period.

From the Department of Anesthesiology, Kawasaki Municipal Hospital, Kawasaki City, Kanagawa, Japan.

Accepted for publication August 24, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Yoshimune Osaka, MD, PhD, Department of Anesthesiology, Kawasaki Municipal Hospital, 12-1 Shinkawa St, Kawasaki-ku, Kawasaki City, Kanagawa 210-0013, Japan. Address e-mail to

© 2019 International Anesthesia Research Society
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