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Anaesthesia · Special anaesthesia: sickle cell disease
Sample itemWhich perioperative measure helps to prevent sickling in a patient with sickle cell disease?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Maintain oxygenation, hydration and warmth
Hypoxia, acidosis, dehydration, hypothermia and stasis promote haemoglobin S polymerisation. Perioperative care therefore focuses on oxygen, fluids, warming, adequate analgesia and avoiding hypotension. Tourniquets are used cautiously, if at all.
Option by option
A. Restrict intravenous fluids
Dehydration increases blood viscosity and promotes sickling.
B. Maintain oxygenation, hydration and warmth (correct)
Correct. Oxygen, fluids and warmth reduce the triggers for sickling.
C. Allow mild hypothermia to reduce metabolism
Hypothermia causes vasoconstriction and promotes sickling.
D. Use routine prolonged tourniquet inflation
A tourniquet causes stasis, hypoxia and acidosis in the limb, which favour sickling.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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