How safe is tourniquet use in sickle-cell disease?

Nineteen patients with sickle-cell haemoglobinopathy (HbSS-14; HbSC-5) aged five years to twenty-three years who had twenty orthopaedic operations performed under tourniquet at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife between June 1987 and May 1991 were studied. The incidence of complications in these patients were compared with a control group of patients with HbAA who had similar operations under tourniquet and were matched for age and sex. There were seven patients with complications in the sickle cell anaemia group and three in the control group. Only three complications in the study group were significant. These were bone pains, severe post-operative pain and jaundice. Another complication was tissue oedema. The incidence of complications was significantly higher in the sickle cell patients than the normal group (P < 0.01). There were no mortalities. All complications resolved within two weeks of non-invasive management.