Postoperative management

Patients with homozygous sickle cell disease are prone to a variety of complications requiring surgery such as hypersplenism, gallbladder disease, avascular necrosis of the femoral head, and osteomyelitis. Perioperative transfusion has become common practice without evidence of a beneficial effect over patients managed without transfusion. A recent study of preoperative transfusion showed no difference other than in transfusion-related complications between a group of patients aggressively managed by lowering the HbS level to below 30 per cent and a more conservative approach raising the hemoglobin level to 10 g/dl.

General anesthesia is readily induced in patients at their steady state hemoglobin level, and blood should be available for replacement of blood lost at surgery. The greatest risk is in the immediate postoperative period with anesthesia-induced respiratory depression and limited chest movement, particularly with upper abdominal surgery such as the gallbladder and spleen. Preoxygenation for 20 min before induction, replacement of blood lost at surgery if necessary, maintenance of oxygen levels during the postoperative period, adequate hydration, pain relief, and physiotherapy, as practised in Jamaica, achieve postoperative outcomes similar to those obtained using preoperative transfusion elsewhere.

Get Rid of Gallstones Naturally

Get Rid of Gallstones Naturally

One of the main home remedies that you need to follow to prevent gallstones is a healthy lifestyle. You need to maintain a healthy body weight to prevent gallstones. The following are the best home remedies that will help you to treat and prevent gallstones.

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