Anesthesia Considerations 

Wegener's Granulomatosis

 

 

Considerations

 

• Potential difficult airway: laryngeal stenosis, subglottic stenosis, tracheal stenosis, friable bleeding tissue

• Multisystem granulomatous disease:

  • CNS: cerebral aneurysms, peripheral neuropathy

  • Cardiovascular: cardiac valve destruction, conduction defects, myocardial ischemia

  • Pulmonary: sinusitis, pulmonary fibrosis, pulmonary hypertension, pneumonia, hemoptysis, & bronchial destruction

  • Renal: hematuria, renal failure

• Possible contraindication to arterial line due to peripheral arteritis

• Medications including immunosupressants

 

 

Goals & Conflicts

 

• Careful airway management

• Document neurologic deficits prior to regional techniques

• May present with massive hemoptysis & require emergency lung isolation