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[Pain management in sickle cell disease].

T Rasche1, D Emmert1, H Seidel2

  • 1Zentrum für seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Deutschland.

Schmerz (Berlin, Germany)
|May 6, 2020
PubMed
Summary

Sickle cell disease causes significant acute and chronic pain, impacting patient quality of life. Effective pain management, using WHO guidelines for crises and specific medications for chronic or neuropathic pain, is essential.

Keywords:
Acute painful crisisAnalgesics, opioid, long-actingAnalgesics, opioid, short-actingChronic painNeuralgia

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Area of Science:

  • Hematology
  • Pain Medicine
  • Pharmacology

Background:

  • Sickle cell disease (SCD) presents with diverse complications.
  • Acute painful crises are a hallmark of SCD.
  • Chronic pain affects many SCD patients, diminishing quality of life.

Purpose of the Study:

  • To outline current pain management strategies for sickle cell disease.
  • To provide guidance on treating acute painful crises and chronic pain in SCD.
  • To address neuropathic pain considerations in SCD management.

Main Methods:

  • Review of established pain management guidelines, including the World Health Organization (WHO) analgesic ladder.
  • Discussion of pharmacological approaches for acute and chronic pain in SCD.
  • Consideration of specific treatments for neuropathic pain.

Main Results:

  • Acute painful crises in SCD can be managed using the WHO analgesic ladder.
  • Chronic pain in SCD may be treated with long-acting and short-acting opioids.
  • Neuropathic pain in SCD patients may benefit from anticonvulsants, antidepressants, or ketamine.

Conclusions:

  • Adequate pain management is critical for improving the quality of life in sickle cell disease patients.
  • A stepwise approach is recommended for managing SCD-related pain.
  • Tailored pharmacological interventions are necessary for different pain types in SCD.