Anaesthetic Management for ? Thalassemia Major Patient with Massive Splenomegaly for Splenectomy

A 14 yr old ? Thalassemia Major patient with massive splenomegaly scheduled for elective splenectomy. Diagnosed at age 7, he exhibited easy fatigability, pallor, maxillary hyperplasia, and hepatomegaly. Initial hemoglobin was 7.9 g/dL increased to 8.7 g/dL post transfusion. Investigations showed elevated bilirubin and liver enzymes, with a peripheral smear indicating microcytic hypochromic anaemia. After obtaining informed consent, a 20G IV line was established, and monitoring commenced. General anaesthesia was induced with IV propofol and succinylcholine, followed by intubation with a 5.5 cuffed endotracheal tube. Anaesthesia was maintained with sevoflurane and titrated doses of atracurium and fentanyl. Intraoperative blood loss was 200 mL, with fluid replacement managed appropriately. Neuromuscular blockade was reversed, and the patient was extubated after suctioning. The postoperative period was uneventful, and discharge occurred on the 10th day. In conclusion, managing ? Thalassemia Major requires careful preoperative assessment and readiness for complications.