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Published on: November 5, 2019

Changes in intensity, location, and quality of vaso-occlusive pain in children with sickle cell disease

Eufemia Jacob1, Christine Miaskowski, Marilyn Savedra

  • 1Children's Hospital Oakland, 747, 52nd Street, Oakland, CA 94602, USA. exjacob@txccc.org

Pain
|March 7, 2003
PubMed

Insights

Children with sickle cell disease experience severe pain during vaso-occlusive episodes. Pain intensity scores decreased slightly but not clinically significantly, indicating inadequate assessment and management during hospitalization.

Area of Science:

  • Pediatric Hematology
  • Pain Management
  • Sickle Cell Disease Research

Background:

  • Vaso-occlusive episodes are a hallmark of sickle cell disease (SCD), causing significant pain in children.
  • Effective pain management is crucial for improving the quality of life for pediatric SCD patients.
  • Current assessment and management strategies for SCD pain during hospitalization require further investigation.

Purpose of the Study:

  • To examine changes in pain intensity, location, and quality during hospitalization for vaso-occlusive episodes in children with SCD.
  • To evaluate the clinical significance of pain management interventions based on established guidelines.
  • To identify potential gaps in the assessment and management of SCD-related pain.

Main Methods:

  • A descriptive, longitudinal study design was employed.
  • Data were collected on current, worst, and least pain intensity, pain location, and pain quality using the adolescent pediatric pain tool.
  • Pain scores were analyzed over the course of hospitalization.

Main Results:

  • Children reported severe pain upon admission, with high current (>70) and worst (>80) pain intensity scores in 50% of episodes.
  • Statistically significant but not clinically significant decreases (approx. 5%) in pain intensity were observed during hospitalization.
  • Pain location surface area decreased in 100% of episodes, while pain intensity did not decrease in 25% of episodes.
  • Children utilized all descriptor categories from the adolescent pediatric pain tool to describe pain quality.

Conclusions:

  • Pain associated with vaso-occlusive episodes in children with SCD is often inadequately assessed and managed during hospitalization.
  • The observed decreases in pain intensity were not clinically meaningful, suggesting a need for improved pain management protocols.
  • Further research is warranted to optimize pain assessment and treatment strategies for pediatric SCD patients.

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