TYK342

A 12 year-old female with a longstanding history of sickle cell disease presents to the operating suite for placement of a tunneled central venous catheter for intravenous access. She reports her current pain score to be 8/10. Which of the following is important to prevent sickle cell crisis after anesthesia?

a) Maintain euvolemia

b) Avoid hypothermia

c) Avoid hypoxemia

d) Answers “a” and “c”

e) All of the above

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Answer

Answer e. All answers shown are known triggers of sickle cell crisis. It is critical to avoid hypovolemia, hypoxia, and hypothermia in these patients. Not only can complications be painful, but vas-occlusive crisis may cause tissue ischemia and necrosis. It would also be appropriate to transfuse this patient with packed RBCs prior to surgery (in consultation with her hematologist).

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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