# Spinal Anesthesia With Short-Term Prophylaxis in a Patient With Hereditary Angioedema: A Case Report

## TL;DR

A patient with hereditary angioedema successfully underwent surgery with spinal anesthesia and short-term prophylaxis to prevent attacks.

## Contribution

This case report demonstrates the effectiveness of short-term prophylaxis with plasma-derived C1 inhibitor during spinal anesthesia in a patient with HAE.

## Key findings

- Intravenous plasma-derived C1 inhibitor rapidly resolved preoperative HAE symptoms.
- Spinal anesthesia with pdC1-INH prophylaxis allowed safe surgery without postoperative HAE attacks.
- Short-term prophylaxis may be a viable strategy for managing HAE patients during surgical procedures.

## Abstract

Hereditary angioedema (HAE) is a rare genetic disorder characterized by recurrent episodes of edema affecting various body regions. Upper airway edema is a life-threatening condition that can progress to complete airway obstruction. Patients are particularly likely to encounter several triggering factors for HAE attacks during the preoperative period, necessitating specialized management.

An 80-year-old woman with an established diagnosis of HAE was scheduled to undergo bipolar hip arthroplasty following a femoral neck fracture. During pre-surgical hospitalization, she developed pharyngeal discomfort and hoarseness, which were diagnosed as HAE attacks. Immediate treatment with an intravenous plasma-derived C1 inhibitor (pdC1-INH) resulted in rapid resolution of the symptoms. Surgery was performed as scheduled under spinal anesthesia with the administration of a pdC1-INH as short-term prophylaxis. No postoperative HAE attacks were observed.

Surgical intervention in patients with HAE requires specialized care, and short-term prophylaxis may be useful in preventing HAE attacks.