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Related Concept Videos

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Peripheral Artery Disease IV: Nursing Management

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Analgesia and Pain Management

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Related Experiment Video

Updated: Jul 10, 2026

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
05:23

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Published on: March 14, 2017

Current issues in sickle cell pain and its management.

Samir K Ballas1

  • 1Cardeza Foundation, 1015 Walnut Street, Philadelphia PA 19107, USA. samir.ballas@mail.tju.edu

Hematology. American Society of Hematology. Education Program
|November 21, 2007
PubMed
Summary

Sickle cell disease pain crises are a major cause of hospital admissions. Understanding pain phases and opioid mechanisms is key for effective, individualized pain management to prevent chronic pain.

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Last Updated: Jul 10, 2026

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
05:23

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Published on: March 14, 2017

Area of Science:

  • Hematology
  • Pain Medicine
  • Pharmacology

Background:

  • Pain is a hallmark of sickle cell disease (SCD), with acute painful crises driving hospitalizations.
  • Vaso-occlusion in SCD triggers inflammation, leading to pain signal transmission and perception.
  • Acute painful crises in SCD progress through distinct phases, accompanied by changes in disease markers.

Purpose of the Study:

  • To elucidate the phases of acute sickle cell painful crises.
  • To explore the role of inflammatory mediators in SCD pain.
  • To highlight the importance of individualized pharmacologic management for SCD pain.

Main Methods:

  • Review of SCD pathophysiology focusing on vaso-occlusion and inflammation.
  • Analysis of the temporal evolution of acute painful crises.
  • Examination of opioid pharmacology and its implications for patient variability.

Main Results:

  • Acute painful crises in SCD involve four distinct phases with associated marker changes.
  • Inflammatory mediators released during vaso-occlusion are central to pain generation.
  • Approximately 16% of patients are readmitted within one week of discharge.
  • Inadequate acute pain management increases the risk of developing chronic pain syndrome.

Conclusions:

  • Aggressive and individualized pain management, particularly with opioids, is crucial for SCD patients.
  • Understanding opioid mechanisms can guide personalized treatment plans to address patient variability.
  • Effective management of acute pain is essential to prevent the transition to chronic pain.