Annals for Hospitalists Inpatient Notes - Clinical Pearls—Acute Pain Episodes in Sickle Cell Disease
Authors: John J. Strouse, Amanda M. Brandow
Journal: Annals of Internal Medicine (2022)

Web ExclusivesMarch 2022Annals for Hospitalists Inpatient Notes - Clinical Pearls—Acute Pain Episodes in Sickle Cell DiseaseJohn J. Strouse, MD, PhD and Amanda M. Brandow, DO, MSJohn J. Strouse, MD, PhDDivision of Hematology, Department of Medicine and Division of Pediatric Hematology–Oncology, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina (J.J.S.)Search for more papers by this author and Amanda M. Brandow, DO, MSDepartment of Pediatrics, Section of Hematology, Oncology, Bone Marrow Transplantation, Medical College of Wisconsin, Milwaukee, Wisconsin (A.M.B.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-0305 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A 24-year-old woman with sickle cell anemia presents to the emergency department (ED) with severe (9 out of 10) pain in her lower back and legs. She has had moderate pain for 24 hours with poor sleep, reduced appetite, and good fluid intake. She took 600 mg of ibuprofen and 10 mg of oxycodone without improvement. She had no fever, shortness of breath, or cough. She takes oxycodone a few days per month and has 2 to 3 ED visits and 1 to 3 hospitalizations per year. She received 1 L of normal saline over 30 minutes, 30 mg of ...References1. Brandow AM, Carroll CP, Creary S, et al. American Society of Hematology 2020 guidelines for sickle cell disease: management of acute and chronic pain. Blood Adv. 2020;4:2656-2701. [PMID: 32559294] doi:10.1182/bloodadvances.2020001851 CrossrefMedlineGoogle Scholar2. Tanabe P, Silva S, Bosworth HB, et al. A randomized controlled trial comparing two vaso-occlusive episode (VOE) protocols in sickle cell disease (SCD). Am J Hematol. 2018;93:159-168. [PMID: 29047145] doi:10.1002/ajh.24948 CrossrefMedlineGoogle Scholar3. Gonzalez ER, Bahal N, Hansen LA, et al. Intermittent injection vs patient-controlled analgesia for sickle cell crisis pain: comparison in patients in the emergency department. Arch Intern Med. 1991;151:1373-8. [PMID: 2064488] CrossrefMedlineGoogle Scholar4. Carden MA, Brousseau DC, Ahmad FA, et al; Sickle Cell Disease Arginine Study Group and the Pediatric Emergency Care Applied Research Network (PECARN). Normal saline bolus use in pediatric emergency departments is associated with poorer pain control in children with sickle cell anemia and vaso-occlusive pain. Am J Hematol. 2019;94:689-696. [PMID: 30916794] doi:10.1002/ajh.25471 CrossrefMedlineGoogle Scholar5. Naik RP, Streiff MB, Haywood C, et al. Venous thromboembolism in adults with sickle cell disease: a serious and under-recognized complication. Am J Med. 2013;126:443-9. [PMID: 23582935] doi:10.1016/j.amjmed.2012.12.016 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Division of Hematology, Department of Medicine and Division of Pediatric Hematology–Oncology, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina (J.J.S.)Department of Pediatrics, Section of Hematology, Oncology, Bone Marrow Transplantation, Medical College of Wisconsin, Milwaukee, Wisconsin (A.M.B.).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-0305.Corresponding Author: Amanda M. Brandow, DO, MS, Section of Hematology, Oncology, Bone Marrow Transplantation, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - March 2022 Megan Mack , Matthew Luzum , and David H. Wesorick Metrics March 2022Volume 175, Issue 3Page: HO2-HO3KeywordsHematology and oncologyOpioidsPain managementPatient controlled anesthesiaSickle cell disease ePublished: 15 March 2022 Issue Published: March 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...