Perioperative Anaesthetic Approach in a Homozygous Sickle Cell Anaemia Patient with Frequent Pain Crises

Sickle cell disease (HbS) is a haemolytic anaemia characterized by the formation of abnormal haemoglobin. In patients with sickle cell disease, high rates of erythrocyte generation, degradation, and hyperbilirubinemia increase the risk for cholelithiasis. Previous studies have found that the incidence of cholelithiasis is 70% in adult patients. In sickle cell disease, decreased oxygen concentration leads to the sickling of erythrocytes by causing aggregation and polymerization. Sickle erythrocytes can have devastating effects on many vital organs by causing microvascular occlusion. In patients with sickle cell anaemia, anaesthetic technique, anaesthetic agents, and surgical trauma may cause additional risk. In this case report, we present a perioperative anaesthetic approach in the laparoscopic cholecystectomy of a patient with HbS, elevated liver function tests, and frequent pain crises.