How I treat acute and persistent sickle cell pain

Sickle pain is the hallmark of sickle cell disease (SCD). It could be acute, persistent/relapsing, chronic or neuropathic. Although there is a general consensus that pain is a major manifestation of SCD there is a controversy as to the types of pain and their interrelationship between acute, chronic...

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Main Author: Samir Ballas
Format: Article
Language:English
Published: PAGEPress Publications 2020-08-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
Subjects:
Online Access:https://www.mjhid.org/index.php/mjhid/article/view/4297
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author Samir Ballas
author_facet Samir Ballas
author_sort Samir Ballas
collection DOAJ
description Sickle pain is the hallmark of sickle cell disease (SCD). It could be acute, persistent/relapsing, chronic or neuropathic. Although there is a general consensus that pain is a major manifestation of SCD there is a controversy as to the types of pain and their interrelationship between acute, chronic, relapsing, persistent, etc. This report first reviews the general approach to the management of acute vaso-occlusive crisis (VOC) pain including education, counseling, pharmacotherapy, non-pharmacotherapy, and fluid therapy. This is followed by the presentation of five patients that represent typical issues that are commonly encountered in the management of patients with SCD. These issues are: individualized treatment of pain, bilaterality of pain, use of illicit drugs, tolerance to opioids, opioid induced hyperalgesia and withdrawal syndrome. The clinical aspects and management of each of these issues are described. Moreover, such complications as tolerance and withdrawal may persist after discharge and may be mistaken as chronic pain rather than resolving, persistent or relapsing pain.
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institution Kabale University
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spelling doaj-art-cfeaaf9f40ce4d6b90db524c9dfbd4702025-01-02T00:22:50ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062020-08-0112110.4084/mjhid.2020.064How I treat acute and persistent sickle cell painSamir Ballas0Cardeza Foundation for Hematologic Research, Philadelphia.Sickle pain is the hallmark of sickle cell disease (SCD). It could be acute, persistent/relapsing, chronic or neuropathic. Although there is a general consensus that pain is a major manifestation of SCD there is a controversy as to the types of pain and their interrelationship between acute, chronic, relapsing, persistent, etc. This report first reviews the general approach to the management of acute vaso-occlusive crisis (VOC) pain including education, counseling, pharmacotherapy, non-pharmacotherapy, and fluid therapy. This is followed by the presentation of five patients that represent typical issues that are commonly encountered in the management of patients with SCD. These issues are: individualized treatment of pain, bilaterality of pain, use of illicit drugs, tolerance to opioids, opioid induced hyperalgesia and withdrawal syndrome. The clinical aspects and management of each of these issues are described. Moreover, such complications as tolerance and withdrawal may persist after discharge and may be mistaken as chronic pain rather than resolving, persistent or relapsing pain.https://www.mjhid.org/index.php/mjhid/article/view/4297Sickle cell diseaseSickle cell anemiaPainVaso-occlusive crisis
spellingShingle Samir Ballas
How I treat acute and persistent sickle cell pain
Mediterranean Journal of Hematology and Infectious Diseases
Sickle cell disease
Sickle cell anemia
Pain
Vaso-occlusive crisis
title How I treat acute and persistent sickle cell pain
title_full How I treat acute and persistent sickle cell pain
title_fullStr How I treat acute and persistent sickle cell pain
title_full_unstemmed How I treat acute and persistent sickle cell pain
title_short How I treat acute and persistent sickle cell pain
title_sort how i treat acute and persistent sickle cell pain
topic Sickle cell disease
Sickle cell anemia
Pain
Vaso-occlusive crisis
url https://www.mjhid.org/index.php/mjhid/article/view/4297
work_keys_str_mv AT samirballas howitreatacuteandpersistentsicklecellpain