<prompt> Which anesthetic modality is to be avoided in sickle cell disease?General AnesthesiaBrachial Plexus BlockIntravenous Regional AnesthesiaSpinal Anesthesia  <response>: Prevention of conditions that favor suckling is the basis of peri-operative management.Supplemental oxygen is recommended during and after regional anesthesiaGA.Circulatory stasis can be prevented with hydration and anticipation of intraoperative blood loss in order to avoid acute hypovolemiaNormothermia is desirable because hyperthermia increases the rate of gel formation, and hypothermia produces vasoconstriction that impairs organ blood flow.The use of a tourniquet and hence Biers block intravenous regional anesthesia is contraindicated because blood stasis can cause local acidosis, hypoxia with suckling of cells.Drugs commonly used for anesthesia should not have significant effects on the suckling process. 