Hostname: page-component-7c8c6479df-xxrs7 Total loading time: 0 Render date: 2024-03-28T12:56:02.467Z Has data issue: false hasContentIssue false

Anaesthetic care for sickle cell disease

Published online by Cambridge University Press:  16 August 2006

T. Frietsch
Affiliation:
Department of Anesthesiology and Intensive Care, Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-Universitat Heidelberg, D-68167 Mannheim, Germany
I. Ewen
Affiliation:
Department of Anesthesiology and Intensive Care, Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-Universitat Heidelberg, D-68167 Mannheim, Germany
K. F. Waschke
Affiliation:
Department of Anesthesiology and Intensive Care, Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-Universitat Heidelberg, D-68167 Mannheim, Germany
Get access

Abstract

Despite the high frequency of sickle cell disease in Europe, the disease is poorly managed. Critical periods are the hospital stays during which the anaesthe-siologist plays an important role. Understanding the molecular basis of polymerization processes of haemoglobin S can help to avoid triggering a crisis. Differentiation of the various haemoglobin phenotypes helps to estimate the individual perioperative risk. Knowledge of the patient's history and the actual haemoglobin S level facilitates general anaesthesia, surgery and postoperative care. Damage to liver, spleen, eyes, bones, lung and central nervous system increases the perioperative risk. Preoperative preparation includes early admission, intravenous volume substitution, continuing pain therapy and prophylactic antibiotic medication. General anaesthesia seems to be better for patients with a high-risk profile rather than regional anaesthesia. Careful perioperative and postoperative monitoring should allow hypoxaemia, hypovolaemia, hypothermia, acidosis and overtrans-fusion to be avoided. Effective pain therapy includes a combination of opioids with peripherally acting analgesia.

Type
Review
Copyright
2001 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)