Perioperative sickle cell anemia considerations for total hip arthroplasty: case report
Sickle cell anemia or drepanocytosis is a hemoglobinopathy with autosomal recessive inheritance. A longer life expectancy of these patients and the fact that 50% have aseptic osteonecrosis of the hip make total hip arthroplasty a frequent procedure. We present the case of a 34-year-old male diagnosed with homozygous sickle cell disease scheduled for surgery in the operating room. Our aim is to offer perioperative strategies based on a multidisciplinary approach among anesthesiologists, surgeons, and hematologists to avoid complications of the disease itself, exacerbated by moderate-high risk surgeries.
2. Firth PG. Anaesthesia for peculliar cells-a century of sickle cell disease. Br J Anaesth 2005;95:287-299.
3. Adjepong KO, Otegbeye F, Adjepong YA. Perioperative management of sickle cell disease. Mediterr J Hematol Infect Dis 2018;10:e2018032.
4. Howard J, Malfroy M, Llewelyn C, et al. The Transfusion Alternatives Preoperatively in Sickle Cell Disease (TAPS) study: a randomised, controlled, multicentre clinical trial. Lancet 2013;381:930-938.
5. Firth PG, Head CA. Sickle disease and anesthesia. Anesthesiology 2004;101:766-785.
6. Vichinsky EP, Neumayr LD, Haberkern C, et al. The perioperative complication rate of orthopedic surgery in sickle cell disease: report of the National Sickle Cell Surgery Study Group. Am J Hematol 1999;62:129-138.
7. Pignatti M, Zanella S, Borgna-Pignatti C. Can the surgical tourniquet be used in patients with sickle cell disease or trait? A review of the literature. Expert Rev Hematol 2017; 10:175-182.
8. Cela E, Cervera A, Díaz de Heredia C et al. Guía de práctica clínica sobre enfermedades de células falciformes pediátrica. Sociedad Española de Hematología y Oncología Pediátricas. SEHOP; 2010.
9. Vichinsky EP, Haberkern CM, Neumayr L, et al. A comparison of conservative and aggressive transfusion regimens in the perioperative management of sickle cell disease. The Preoperative Transfusion in Sickle Cell Disease Study Group. N Engl J Med 1995;333:206-213.
10. Estcourt LJ, Fortin PM, Trivella M, et al. Preoperative blood transfusions for sickle cell disease. Cochrane Database of Syst Rev 2016;4:CD003149.