title: Epidural analgesia for treatment of a sickle cell crisis during pregnancy.
abstract: BACKGROUND
  More than 50% of obstetric patients with sickle cell disease will have a pain crisis during pregnancy, and the management of these cases can be challenging.
  
  
  METHODS
  A 20-year-old African American with sickle cell disease presented at 29 4/7 weeks of gestation with severe, debilitating leg and back pain. Large doses of intravenous narcotics did not result in significant pain relief, so a lumbar epidural was placed. This resulted in complete pain relief within several minutes. The patient's symptoms resolved over several days and after a short course of narcotics she was discharged to home, and the remainder of her pregnancy was uncomplicated.
  
  
  CONCLUSIONS
  Epidural anesthesia should be considered as a potentially effective treatment for a severe sickle cell crisis in obstetric patients.
authors.affiliation: From the Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD; Department of Anesthesiology, Johns Hopkins University, Baltimore, MD.
authors.forename: Abigail D
authors.initials: AD
authors.lastname: Winder
authors.forename: Stacie
authors.initials: S
authors.lastname: Johnson
authors.forename: Jamie
authors.initials: J
authors.lastname: Murphy
authors.forename: Robert M
authors.initials: RM
authors.lastname: Ehsanipoor
mesh_terms: D015360:Analgesia, Epidural / Q000379:methods*; D000755:Anemia, Sickle Cell / Q000188:drug therapy*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009294:Narcotics / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D009294:Narcotics