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BJA Advance Access originally published online on April 29, 2005
British Journal of Anaesthesia 2005 95(3):287-299; doi:10.1093/bja/aei129
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org

REVIEW ARTICLE

Anaesthesia for peculiar cells—a century of sickle cell disease

P. G. Firth*

Nuffield Department of Anaesthetics, The John Radcliffe, Headley Way, Headington, Oxford OX3 9DU, UK

* E-mail: pgfirth{at}doctors.org.uk

Sickle cell disease is a congenital haemoglobinopathy with a high incidence of perioperative complications. Traditional anaesthetic management, based largely on extrapolation from biochemical models, has emphasized avoidance of red cell sickling to prevent exacerbations of the disease. This historical review outlines the evolution of the traditional approach to sickle cell pathology, assesses the validity of this model, describes the emergence of the concept of the disease as one defined by chronic inflammatory vascular damage, and outlines the practical implications of this new approach.


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