Anesthetic management of patients with sickle cell disease posted for bipolar prosthesis

Abstract

In case of surgical procedures in sickle cell disease (SCD), patients are associated with high risk of perioperative complications like vaso-occlusive crisis, chest syndrome, post-operative infections, congestive heart failure, cerebrovascular accident and acute kidney injury. Preoperative assessment and stabilization like control of sepsis, blood transfusion, correction of hypoxia, hypothermia, dehydration and acidosis is needed to reduce peri-operative complications. Blood transfusion (Simple, manual exchange and automated exchange) remains an important therapeutic intervention in patients with SCD. The case study below shows the perioperative management of patients posted for bipolar prosthesis due to AVN (avascular necrosis). Adequate analgesia, incentive spirometry, early mobilisation and oxygen supplementation is the mainstay of post-operative management.