Sickle cell states and the anaesthetist

Anesthetic management of pregnant women with sickle cell disease — effect on postnatal sickling complications

“…2,[10][11][12][13] In a review on SCD and anesthesia published in 1988, the authors stated that, "the choice of regional or general anesthesia for obstetric patients depends on the patient's general condition and the preference of the anesthesiologist, rather than specific indication". 10 According to others, regional anesthesia could be safely used for Cesarean delivery. 11 However, it was suggested, in a large study, that regional anesthesia may be associated with higher sickling complications.…”

“…9 Whatever the choice of anesthetic technique, it is important to avoid hypothermia, hypoxemia, hypovolemia, acidosis, and hypotension. 1,[10][11][12][13] Ephedrine is an acceptable drug for normalizing blood pressure. 9 It has been speculated that pressors, which can produce vasoconstriction and stasis, should be avoided whenever possible in SCD, 10 because these conditions may increase the risk of sickling.…”

“…1,[10][11][12][13] Ephedrine is an acceptable drug for normalizing blood pressure. 9 It has been speculated that pressors, which can produce vasoconstriction and stasis, should be avoided whenever possible in SCD, 10 because these conditions may increase the risk of sickling. 3,13 Apart from its vasoconstrictive effect, ephedrine, like epinephrine, 20 could also initiate or exacerbate vaso-occlusion via activation of red cell adhesion.…”

“…9 Nevertheless, no consensus exists concerning the anesthetic care of parturients with SCD. [10][11][12][13] The aim of this retrospective study was to determine the possible relationship between anesthetic technique and the occurrence of postpartum sickling complications.…”

Anaesthesia for renal transplantation in sickle cell disease

“…For a review of the aetiology, clinical features, complications and general management of SCD, the reader is referred to Serjeant, t Weatherall, 2 and Abdalla. 3 The anaesthetic problems associated with sickle cell states have been reviewed recently by Esseltine et al 4 Renal manifestations of SCD include hyposthenuria, polyuria, haematuria, proteinuria, glomerulonephritis, pyelonephritis and the nephrotic syndrome. 5-~z Endstage renal disease (ESRD) is common in adult patients with SCD and some of the complications of renal failure, especially acidosis, cardiac failure, fluid and electrolyte disorders, can encourage sickling.…”