Canterbury DHB
|
|
|
Dosage levels depend on the precise nature of the procedure. Plan the treatment regimen in consultation with the oral surgeon.
Nerve blocks (e.g. inferior dental nerve block) are not contraindicated provided satisfactory factor levels are achieved and there is close liaison between a haematologist and dental surgeon experienced in the management of haemophilia.
Infiltration local anaesthesia has a low risk of complications and periodontal (intraligamental) local anaesthesia can be used without risk.
Aim: To increase factor levels to 30%, follow-up treatment according to response.
Use local and/or systemic antifibrinolytic agents.
Treatment Regimen |
FVIII 15 to 20 u/kg pre-operatively, repeat dose next day if required. |
FIX 30 u/kg pre-operatively, repeat dose next day if required. |
|
Tranexamic acid syrup (500 mg/5 mL) 5 to 10 mL six-hourly, hold in mouth ³ 2 minutes before swallowing. |
|
An alternative is to crush tranexamic acid tablets in warm water and use as a mouthwash. (This tastes more bitter than the syrup). |
|
If not swallowed, consider giving additional systemic tranexamic acid tablets (1 g four times a day orally) |
Aim: To increase factor level to 40 to 60%, with multiple dosing or continuous infusion.
Treatment Regimen |
FVIII 20 to 30 u/kg pre-operatively ® 20 u/kg at 12 hours ® 20 u/kg at 24 hours |
FIX 40 u/kg pre-operatively ® 20 u/kg at 12 hours ® 20 u/kg at 24 hours |
|
Tranexamic acid syrup (500 mg/5 mL) 5 to 10 mL six-hourly; hold in mouth ³ 2 minutes before swallowing. If not swallowed, consider giving additional systemic tranexamic acid (1 g four times a day orally). |
|
Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document.
|
|
Topic Code: 5251
Disclaimer