ANAESTHETIC MANAGEMENT OF A 26 YEARS OLD PREGNANT WOMEN WITH A KNOWN CASE OF SICKLE CELL DISEASE PLANNED FOR EMERGENCY CESAREAN SECTION

Abstract

A26 years old pregnant women who is a known case sickle cell disease (ss) presented with respiratory distress and severe anemia planned for emergency cesarean section . After preoperative optimisation with 4 units of blood transfusion and oxygenation via facemask operative intervention was carried out under combine spinal epidural anaesthesia . A sensory block level of T6 is achieved with intrathecal injection 10 mg of hyperbaric bupivacaine with 25 microgram of injection fentanyl .Intraoperatively 1 units of blood transfusion was done under regular ABG monitoring to prevent acid -base inbalance, hypoxia, acidosis , hypothermia and hypercarbia . Postoperative analgesia was provided through the epidural catheter with 6 ml of ( inj 0.125% of bupivacaine + 25 microgram of inj fentanyl) every 12 hourly for 3 days. She was discharged from the postnatal ward on 5 th day following surgery with a healthy male baby . Pregnancy associated with sickle cell disease carries a high risk of maternal and neonatal mortality and morbidity. It provide a great challenge to anaesthesiologist during perioperative management. The uneventful course of anaesthesia in this case is managed with systemic evaluation and careful anaesthetic strategy