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Pain in children and adolescents with sickle cell anemia: a prospective study utilizing self-reporting
K A Sporrer1, S M Jackson, S Agner
1Department of Pharmacy, Medical University of South Carolina, Charleston 29425.
Insights
Adolescents with sickle cell anemia (SCA) report more severe pain during vaso-occlusive crises than younger children. Pain scores can help predict hospitalization length in SCA patients.
Area of Science:
- Pediatric Hematology
- Pain Management
- Sickle Cell Disease Research
Background:
- Sickle cell anemia (SCA) causes painful vaso-occlusive crises.
- Effective pain management is crucial for pediatric SCA patients.
- Understanding pain reporting differences is key for tailored treatment.
Purpose of the Study:
- To characterize pain reporting in children with SCA during vaso-occlusive crises.
- To evaluate a pain management protocol based on patient self-reports.
- To identify age-related differences in pain perception and reporting.
Main Methods:
- Seventeen pediatric patients (3-18 years) with SCA (Hb SS) admitted for painful crises participated.
- Pain was self-reported on a 0-5 rating scale.
- Statistical analyses (Mann-Whitney, Kruskal-Wallis) compared pain scores, number of painful sites, and hospitalization duration between age groups (3-12 vs. 13-18 years).
Main Results:
- Adolescents (13-18 years) reported significantly higher pain severity than younger children (3-12 years).
- Pain severity did not correlate with the number of painful body sites.
- Longer hospital stays were associated with more painful sites and higher initial pain scores (>2 at 24h).
Conclusions:
- A pain management protocol using self-reported pain was effective for analgesia during crises.
- Distinct differences exist in pain self-reporting between young children and adolescents with SCA.
- Pain scores can serve as a predictive tool for hospitalization duration in pediatric SCA patients.
Purpose:
The purpose of this study was to characterize pain reporting among children with sickle cell anemia (SCA) experiencing painful vaso-occlusive crises. These patients were managed according to a protocol based on self-reports of pain.
Patients And Methods:
Seventeen children (3-18 years) with SCA (Hb SS) who were admitted for painful crisis were asked to report their pain according to a rating scale of 0-5. These pain scores were analyzed according to the Mann-Whitney method to determine differences in pain reporting among young children (3-12 years) and adolescents (13-18 years). The Kruskal-Wallis method was utilized to determine relationships between the number of painful body sites, reported pain scores, and length of hospital stay.
Results:
Children (3-12 years) reported significantly less severe pain than adolescents (13-18 years) (p < 0.01). The severity of pain reported was not related to the number of painful sites. However, the length of stay was significantly longer in patients with greater numbers of painful sites (p < 0.05). Patients who reported pain scores of > 2 at 24 h had significantly longer periods of hospitalization.
Conclusion:
A protocol based upon self-reports of pain was successfully utilized to provide analgesia during painful crises. There were characteristic differences between young children and adolescents in self-reporting of pain. Pain scores may be helpful in predicting length of hospitalization for painful crises.