Individuals with sickle cell disease (SCD) have special perioperative concerns that must be considered before their anesthesia and surgery. During the perioperative period, these individuals are at risk for vaso-occlusive events, including acute chest syndrome, pain crises, priapism and stroke because they are exposed to hypoxia, acidosis, hypothermia, infections and hypovolemia. Several suggestions to reduce risk have been made, including a structural multidisciplinary approach, paying special attention to hydration and oxygenation, postoperative respiratory care and selection of less aggressive or extensive surgical procedures. Even with meticulous care, approximately 25% to 30% of individuals with SCD will have a postoperative complication. This article provides readers with information about the role of surgery in SCD and the measures that should be taken to ensure patients are well cared for in the perioperative period.
Sickle cell disease; surgery; anesthesia