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Sickle cell trait does not convey an increased risk from general anaesthesia. Sickle cell disease increases the risk of both general and local anaesthesia.
Patients of Negroid, Middle Eastern or Mediterranean descent should be specifically asked about their sickle cell status, or if unsure, about a history of unexplained abdominal pain or joint pains. Screening is essential if doubt remains. Patients with sickle cell disease should have a full haematological assessment and the relative risk of a crisis weighed against their need for the procedure: anaesthetists cannot guarantee the absence of hypoxia, acidosis and dehydration perioperatively. Tourniquets should be avoided as they precipitate hypoxic episodes.
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