1 Division of Hematology, Children's Hospital Medical Center, Boston, Massachusetts 02115
The implication by McGarry and Duncan that sickle cell trait carries an increased risk of death following anesthesia should be carefully weighed against their proffered evidence. In two of their five cases, a hematologic diagnosis was not established, but rather implied by postmortem findings. These two cases could therefore represent an additional, mixed, sickle hemoglobinopathy. In addition, postmortem sickling can hardly serve as an indicator of premortem pathophysiology. Since previous firm documentation of anesthetic deaths associated with sickle cell trait are not available, the following questions would seem to be pertinent: (1) what is the overall incidence of anesthetic deaths in the authors' institution and (2) over what period of time were these cases collected?