Case of anesthetic management of a patient with sickle cell disease for pericardiectomy: anterior pericardiotomy and avoiding cardiopulmonary bypass

Authors

DOI:

https://doi.org/10.3126/jsan.v5i1.23214

Keywords:

anesthesia, cardiopulmonary bypass, pericardiectomy, sickle cell disease

Abstract

Patients having sickle cell disease can land up to the anesthetist for various purposes like surgery, acute pain management and intensive care for acute respiratory failure. Our case was of a 20-year-old female patient presented with anemia and symptoms of constrictive pericarditis. Following investigations, which were also suggestive of sickle cell disease, she was planned for pericardiectomy under general anesthesia. We performed anterior pericardiectomy rather than a complete pericardiotomy to avoid cardiopulmonary bypass and to decrease the chance of postoperative complications.

Author Biography

Santosh Sharma Parajuli, Shahid Gangalal National Heart Center

Registrar, Department of Anesthesia

References

<p style="margin-top: 0.0000pt; margin-bottom: 0.0000pt; text-autospace: ideograph-numeric;"><span style="font-family: Calibri; font-size: 10.0000pt;">.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span><span style="font-family: Calibri; font-size: 10.0000pt;">Vinchinsky EP, Lubin BH. Sickle cell anemia and related haemoglobinopathies. </span><span style="font-family: Calibri; font-size: 10.0000pt;">Pediatr Clin North Am </span><span style="font-family: Calibri; font-size: 10.0000pt;">1980;</span><span style="font-family: Calibri; font-size: 10.0000pt;">27</span><span style="font-family: Calibri; font-size: 10.0000pt;">:429</span><span style="font-family: Calibri; font-size: 10.0000pt;">-</span><span style="font-family: Calibri; font-size: 10.0000pt;">47.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span><a href="https://doi.org/10.1016/S0031-3955(16)33860-3"><u><span style="font-family: Calibri; color: #0000ff; text-decoration: underline; text-underline: single; font-size: 10.0000pt;">https://doi.org/10.1016/S0031-3955(16)33860-3</span></u></a><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span></p>
<p style="margin-top: 0.0000pt; margin-bottom: 0.0000pt; text-autospace: ideograph-numeric;"><span style="font-family: Calibri; font-size: 10.0000pt;">.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span><span style="font-family: Calibri; font-size: 10.0000pt;">Bunn HF. Pathogenesis and treatment of sickle cell disease. </span><span style="font-family: Calibri; font-size: 10.0000pt;">N Engl J Med </span><span style="font-family: Calibri; font-size: 10.0000pt;">1997;</span><span style="font-family: Calibri; font-size: 10.0000pt;">337</span><span style="font-family: Calibri; font-size: 10.0000pt;">:762.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span><a href="https://doi.org/10.1056/NEJM199709113371107"><u><span style="font-family: Calibri; color: #0000ff; text-decoration: underline; text-underline: single; font-size: 10.0000pt;">https://doi.org/10.1056/NEJM199709113371107</span></u></a><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;PMid:9287233</span></p>
<p style="margin-top: 0.0000pt; margin-bottom: 0.0000pt; layout-grid-mode: char; text-autospace: ideograph-numeric;"><span style="font-family: Calibri; font-size: 10.0000pt;">.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;Pokharel JN, Sharma A, Upreti MR, Koirala R, Sharma J, Pradhan S. Fast-Track Cardiac Anaesthesia at a Tertiary Care Cardiac Centre in Nepal. Nepalese Heart Journal 2013;10(1):6-11.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span><a href="https://doi.org/10.3126/njh.v10i1.9739"><u><span style="font-family: Calibri; color: #0000ff; text-decoration: underline; text-underline: single; font-size: 10.0000pt;">https://doi.org/10.3126/njh.v10i1.9739</span></u></a><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span></p>
<p style="margin-top: 0.0000pt; margin-bottom: 0.0000pt; text-autospace: ideograph-numeric;"><span style="font-family: Calibri; font-size: 10.0000pt;">.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span><span style="font-family: Calibri; font-size: 10.0000pt;">Goldberg MA, Brugnara C, Dover GJ, Schapira L, Lacroix L, Bunn HF. Treatment of Sickle cell anemia with hydroxyurea and erythropoietin. </span><span style="font-family: Calibri; font-size: 10.0000pt;">N Engl J Med </span><span style="font-family: Calibri; font-size: 10.0000pt;">1990;</span><span style="font-family: Calibri; font-size: 10.0000pt;">323</span><span style="font-family: Calibri; font-size: 10.0000pt;">:366</span><span style="font-family: Calibri; font-size: 10.0000pt;">-</span><span style="font-family: Calibri; font-size: 10.0000pt;">72.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span><a href="https://doi.org/10.1056/NEJM199008093230602"><u><span style="font-family: Calibri; color: #0000ff; text-decoration: underline; text-underline: single; font-size: 10.0000pt;">https://doi.org/10.1056/NEJM199008093230602</span></u></a><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span></p>
<p style="margin-top: 0.0000pt; margin-bottom: 0.0000pt; text-autospace: ideograph-numeric;"><span style="font-family: Calibri; font-size: 10.0000pt;">.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span><span style="font-family: Calibri; font-size: 10.0000pt;">Morrison JC, Whybrew WD, Bucovaz ET. Use of partial exchange transfusion preoperatively in patients with sickle cell hemoglobinopathies. </span><span style="font-family: Calibri; font-size: 10.0000pt;">Am J Obstet Gynecol </span><span style="font-family: Calibri; font-size: 10.0000pt;">1978;</span><span style="font-family: Calibri; font-size: 10.0000pt;">132</span><span style="font-family: Calibri; font-size: 10.0000pt;">:59</span><span style="font-family: Calibri; font-size: 10.0000pt;">-</span><span style="font-family: Calibri; font-size: 10.0000pt;">63.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span><a href="https://doi.org/10.1016/0002-9378(78)90799-8"><u><span style="font-family: Calibri; color: #0000ff; text-decoration: underline; text-underline: single; font-size: 10.0000pt;">https://doi.org/10.1016/0002-9378(78)90799-8</span></u></a><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span></p>
<p style="margin-top: 0.0000pt; margin-bottom: 0.0000pt; text-autospace: ideograph-numeric;"><span style="font-family: Calibri; font-size: 10.0000pt;">.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span><span style="font-family: Calibri; font-size: 10.0000pt;">P</span><span style="font-family: Calibri; font-size: 10.0000pt;">agani</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;FD, P</span><span style="font-family: Calibri; font-size: 10.0000pt;">olito</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;RJ, B</span><span style="font-family: Calibri; font-size: 10.0000pt;">olling</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;SF</span><span style="font-family: Calibri; font-size: 10.0000pt;">.</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;Mitral valve reconstruction in sickle cell disease. Ann Thorac Surg</span><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;1996</span><span style="font-family: Calibri; font-size: 10.0000pt;">;61(6):1841-3</span><span style="font-family: Calibri; font-size: 10.0000pt;">. </span><a href="https://doi.org/10.1016/0003-4975(96)80209-8"><u><span style="font-family: Calibri; color: #0000ff; text-decoration: underline; text-underline: single; font-size: 10.0000pt;">https://doi.org/10.1016/0003-4975(96)80209-8</span></u></a><span style="font-family: Calibri; font-size: 10.0000pt;">&nbsp;</span></p>

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Published

2019-03-15

How to Cite

Parajuli, S. S. (2019). Case of anesthetic management of a patient with sickle cell disease for pericardiectomy: anterior pericardiotomy and avoiding cardiopulmonary bypass. Journal of Society of Anesthesiologists of Nepal, 5(1), 22-24. https://doi.org/10.3126/jsan.v5i1.23214

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Section

Case Report