Elective surgery in patients with sickle cell anemia.

Between July 1977 and October 1981, nine patients with sickle cell anemia underwent tonsillectomy or tonsillectomy with adenoidectomy without operative or postoperative morbidity or mortality. Appropriate management is necessary to prevent vaso-occlusive events. The current protocol for elective surgery used at the Medical College of Georgia, Augusta, consists of the following: (1) preoperative transfusion and hydration, (2) intraoperative prevention of hypothermia and maintenance of blood volume, and (3) postoperative oxygen therapy and hydration. The critical requirement of this protocol is the preoperative transfusion of these patients with packed cells consisting of hemoglobin A erythrocytes to lower the percentage of Hb S to less than 45% as determined by quantitative hemoglobin electrophoresis.