Sickling dynamics of red blood cells and other physiologic studies during anesthesia

Nineteen patients with electrophoretically proven sickle cell diseases were studied prospectively at intervals, using halothane, methoxyflurane, cyclopropane, and fluroxene. Simultaneous venous and arterial samples were taken from the same arm in heparinized syringes at the sampling intervals and analyzed for blood gases, hematocrit, and percent sickle cells. Measurements of blood pressure, pulse, temperature, tidal volume, minute ventilation, and other significant data were recorded. There were no anesthetic deaths, and the morbidity seen was an extension of pre-existing pathology. Sickling was found to be greatly reduced in both arterial and venous blood during anesthesia, with the greater reduction in venous blood. Following anesthesia, sickling returned toward, but often did not reach, pre-anesthetic levels. Blood-gas measurements reflected the slightly increased ventilation and considerably increased inspired oxygen during anesthesia. Other measurements were not remarkable.