Anesthesia for Laparoscopic Cholecystectomy in Sickle Cell Patients: Experience of a Hospital Implementing Laparoscopic Digestive Surgery in Central Africa - Abstract
Objective: The aim of this study was to evaluate the anesthetic management of SS homozygous sickle cell patient, candidate for laparoscopic cholecystectomy. Methods: This was a single-center, retrospective descriptive study that took place in the anesthesia department of the Essos hospital center over a period of 5 years (January 2015 to December 2020). We included all the records of SS homozygous sickle cell patients who received anesthesia for laparoscopic cholecystectomy during the above-mentioned period. The variables studied were the sociodemographic characteristics, anesthetic procedure and postoperative complications. Results:During the survey period, 72 patients met our inclusion criteria. The median age was 19.4 years. The sex ratio was 1.4 in favor of the female gender. Preoperative blood transfusion was performed in 5 patients (6.9%). The anesthetic induction procedure was classic in all participants with thiopental or propofol or ketamine associated with fentanyl and vecuroniun. Intraoperative fluid resuscitation was done with ringer’s lactate (61%), isotonic saline (39%). Sixty-five patients (90.3%) were extubated on the operating table. The postoperative analgesic strategy began in the operating room. We did not find any major complications in the first 24 postoperative hours. Conclusion: Anesthesia for cholecystectomy in sickle cell patients can be performed under optimal safety conditions in an environment hostile to the practice of general anesthesia.