Sickle cell states and the anaesthetist

Esseltine, D. W.; Baxter, Michael R. N.; Bevan, Joan C.

doi:10.1007/bf03010861

Cited by 57 publications

(43 citation statements)

References 112 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

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

Camous

N’da

Etienne‐Julan³

et al. 2008

Can J Anesth/J Can Anesth

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Purpose: Currently, there is no consensus regarding the choice of anesthetic technique for parturients with sickle cell disease (SCD). The aim of the study was to determine the impact of the anesthetic technique on the occurrence of postnatal sickling complications. Methods:We reviewed the charts of all pregnant women with SCD who had given birth in our institution between January 2002 and January 2007. Data related to pregnancy and anesthetic management and complications related, or unrelated, to SCD were recorded. Full blood count and lactate dehydrogenase values were recorded on the day of delivery. Risk factors for postnatal sickling complications were evaluated using a logistic regression analysis to estimate odds ratios (OR) and their 95% confidence intervals (95% CI). Results:Fourteen of the 55 women (24%) experienced at least one postnatal sickling complication. Women who developed postnatal sickling complications were found to have a higher leukocyte count (17.0 ± 6.1 × 10 9 ·L -1 vs 12.8 ± 4.4 ×10 9 ·L -1 , P = 0.008) and a lower hemoglobin level (7.8 ± 1.1 vs 8.9 ± 1.0 g.dL -1 , P = 0.002). General anesthesia (OR = 16.0; 95% CI, 1.6 to 165.6) and a leukocyte count ≥ 15 × 10 9 ·L -1 (OR = 8.4; 95% CI, 1.6 to 44.5) were identified as risk factors. Neuraxial anesthesia and use of ephedrine were not identified as risk factors. There were no deaths. Conclusion: Our study suggests that general anesthesia could be associated with postnatal sickling complications, even when the severity of illness was taken into account.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

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

Camous

N’da

Etienne‐Julan³

et al. 2008

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…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.…”

Section: Clinical Reportsmentioning

confidence: 99%