Management of acute painful crises in sickle cell disease.
Pain is a common mode of manifestation of sickle cell disease (SCD) but there is limited information on pain management in this disorder. This study examines the use of opioids and non-opioid analgesia in the management of painful crisis in adult SCD patients; the routine use of antimalarials and antibiotics as adjunct therapy was also examined. A total of 87% of the patients had had a form of analgesics before presentation, 20% of which had parenteral analgesia. Ten per cent had not used any form of medication while another 10% used non-steroidal anti-inflammatory drugs. When asked, 59% of the patients desired oral non-opioid analgesics while 31% were not concerned about the type of analgesic given. Only 8% requested opioids. Hospital admission was not necessary in 65% of the patients; they were observed in the day-care unit and allowed home within 24 h. Sixty per cent did not have a test for malaria; 66% of those who had the test performed were negative, 35% of those whose thick film for malaria was negative had antimalarials prescribed. Only five patients (7%) were febrile at presentation. Thirty-four per cent had antibiotics prescribed, a third of these parenterally. Thirty-nine per cent had no fever but received antibiotics.
Kotila
T R
TR
Department of Haematology, College of Medicine, University of Ibadan, PMB 5116, Ibadan, Nigeria. taiwokotila@post.com
D000208:Acute Disease; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000755:Anemia, Sickle Cell / Q000503:physiopathology* / Q000628:therapy*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008288:Malaria / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D009294:Narcotics / Q000627:therapeutic use; D009549:Nigeria; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D009294:Narcotics