Alternative Agents in Pharmacological Management of Sickle Cell Pain Crisis Complicated by Acute Pancreatitis

Pain is a prominent presenting complaint in the vaso-occlusive crisis of sickle cell anemia and that of acute pancreatitis. The treatment of pain may extend for hours or days up to weeks for an episode. Treatment by pharmacotherapy often includes opiate/opioid analgesics, nonopiate analgesics and coanalgesics. Repeated acute painful episodes expose the patient to opiate induced effects. This case report describes a treatment option that was developed in order to provide effective analgesia while minimizing the iatrogenic effects produced by commonly used opioids. The use of partial agonists, mixed agonists, nonsteroidal anti-inflammatory agents and coanalgesics can provide objective and subjective analgesia without precipitating drug seeking behaviors or significant iatrogenic effects. Pain management in this clinical setting requires a balanced biopsychosocial approach.