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Table 2 Anaesthestic preparations for patients with EDS

From: Recommendations for anesthesia and perioperative management in patients with Ehlers-Danlos syndrome(s)

Patient history Check for the specific EDS subtype
Perform thorough bleeding anamnesis
Patient history with focus on EDS complications
Check for airway difficulties
Inform patient Inform the patient about relevant Issues of the underlying disorder with regard to planned anaesthesia
Discuss specific anaesthetic risks for general anaesthesia; discuss regional anaesthesia options with regard to the underlying subtype
Discuss with surgeon Discuss the severity of the respective EDS in each specific patient
Has your local centre the appropriate facilities and experience for the planned operation AND the underlying EDS?
Strategies for bleeding therapy in vascular EDS subtypes
Avoidance of tourniquets, adequate patient positioning
Avoid ambulatory surgery
Early mobilization strategy
Organize Cross match blood products, preparation of autotransfusion devices
Difficult airway management (performed by an expert with adequate devices)
Prolonged postoperative care facilities
Inform preoperatively Inform all team members including PACU and ward nurses in advance for optimal patient care
Be aware Typical EDS-related emergency-like situations such as difficult airway status, bleeding risks and organ rupture in specific subtypes
Bleeding prophylaxis Use desmopressin in patients with positive bleeding history
Inform postoperatively Inform the patient of any anaesthetic difficulties. Fill out a detailed anaesthesia problem card or medical report to anticipate difficulties in the future.