ANAESTHETIC MANAGEMENT OF YOUNG MALE WITH SICKLE CELL DISEASE POSTED FOR OPEN CHOLECYSTECTOMY

Abstract

Introduction: An hereditary form of chronic haemolytic anaemia known as sickle cell disease is accompanied by a variety of acute, painful, and vaso-occulusive episodes. The main molecular process behind clinical symptoms is polymerisation of hb-s following deoxygenation. The wellknown consequence of prolonged haemolysis is cholelithiasis. Case Report:A33-year-old man with known sickle cell disease came with 15 days of yellowish discoloration of the mucous membranes, eyes, skin, and skin around the mucous membranes, as well as 10 days of stomach discomfort. He has been receiving frequent blood transfusions and Tab. hydroxyurea for 25 years. Using an ultrasonogram, cholelithiasis was identied, and an open cholecystectomy was scheduled. Prior to surgery, the patient began incentive spirometry. To prevent dehydration, he was kept off of NBM after midnight and put on RLat 100 ml each hour. Athoracic epidural catheter was inserted in the T11-T12 area while under local anaesthesia since the coagulation prole was normal. Discussion: The clinical hallmarks of SCD, vaso-occlusive phenomena and haemolysis, cause a variety of signicant organ system problems as well as repeated painful episodes. To avoid acute chest syndrome and atelectasis, extensive preoperative spirometry was performed. The entire time, enough hydration was kept up. To avoid hypoxia and hypotension, the induction and intubation processes were carried out with the utmost care. To avoid hypothermia, high, warm intravenous uids were administered, and an epidural infusion was employed to deliver sufcient analgesia. Conclusion: Successful care of sickle cell disease requires meticulous anaesthetic control, including preoperative exchange transfusion, avoidance of acidosis, hypoxia, hypothermia, and hypovolemia, as well as maintaining adequate intraoperative and postoperative pain relief using epidural infusion