ANAESTHESIA IN WEST AFRICAN PATIENTS WITH SICKLE-CELL ANAEMIA, HAEMOGLOBIN SC DISEASE, AND SICKLE-CELL TRAIT

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Abstract
Sickling occurs in sickle-cell anaemia, sickle-cell trait and the mixed sickling haemoglobinopathies such as haemoglobin SC disease. The severity of sickle-cell anaemia is apparently greater in West Africa than in the West Indies. Three cases anaesthetized in Ghana are described. Experience of thirty-three cases of heterozygous sickle-cell states indicates that the danger of anaesthesia is greater in haemoglobin SC disease than in sickle-cell trait. Pre-operative treatment of the anaemia is discussed. Sodium bicarbonate, magnesium sulphate, low-molecular weight dextran, heparin, and the phenothiazine derivatives may be useful in prophylaxis and treatment of crisis in the operative period. Hypoxia, acidosis, stasis and cooling should be avoided during anaesthesia.