Use of a tourniquet in patients with sickle-cell disease. ³
Á Adu-Gyamfi Y. Sankarankutty M. Marwa S. Department of Anaesthesiology, King Faisal University, College of Canadian Journal of Anaesthesia-Journal Canadien d Anesthesie. 40(1):24-7, 1993 Jan. Fifteen patients, 13 male and two female, known to be carrying the sickle-cell gene (12 HbSS and 3 HbAS), who were undergoing operations requiring a bloodless field, were included in the study. Of the 12 with HbSS, seven had haemoglobin A1 component of between 11 and 27%, three had fetal haemoglobin ranging from 5.7 to 29% and the remaining two had increased haemoglobin A2 concentrations suggesting a beta non-thalassaemia combination. All had a tourniquet applied to the appropriate limb and were given general anaesthesia with moderate hyperventilation throughout the procedure. The tourniquet inflation time was 61.7 +/- 27.5 min. The mean PaO2 remained above 200 mmHg, mean PaCO2 was less than 37 mmHg, and pH ranged between 7.40 and 7.45. There were no clinically important changes * in BP or ECG. All patients made uneventful recoveries and none developed sickle-cell crises. It is suggested that it is safe to use tourniquet in Á patients with sickle-cell disease provided optimum acid-base status and oxygenation are maintained throughout the procedure. *
Original Text by Clifford R. Wheeless, III, MD.
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