Question:medium
Which anaesthetic modality is to be avoided in a patient with sickle cell disease?
Which anaesthetic modality is to be avoided in a patient with sickle cell disease?
Show Hint
Which technique deliberately exsanguinates the limb and causes stasis and hypoxia?
Updated On: Jun 24, 2026
- General anaesthesia
- Brachial plexus block
- Intravenous regional anaesthesia
- Spinal anaesthesia
Show Solution
The Correct Option is C
Solution and Explanation
The key is to match each anaesthetic technique against the known triggers of red-cell sickling, namely low oxygen, acid pH, sluggish venous blood, dehydration, and cold. Whichever technique forces those conditions is the one to avoid. Consider intravenous regional anaesthesia, the Bier block. Its very method involves squeezing the blood out of the arm and then inflating a tourniquet so the limb is cut off from the circulation while local anaesthetic is held inside it. That arrangement creates exactly the hostile microenvironment, stasis, ischaemia, hypoxia, and acidosis, that drives haemoglobin S to polymerise and the cells to sickle, potentially provoking a vaso-occlusive episode in that limb. The alternatives do not impose this. General anaesthesia, a brachial plexus block, and spinal anaesthesia can all be performed safely provided the patient is kept well oxygenated, warm, hydrated, and perfused. Hence the technique that is specifically hazardous and should be avoided is the IV regional (Bier) block. $IV\ regional\ anaesthesia$ is the answer.\[\boxed{\text{Intravenous regional anaesthesia}}\]
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