title: Successful epidural analgesia for a vaso-occlusive crisis of sickle cell disease during pregnancy: a case report.
abstract: We describe a 19-year-old Cameroonian primigravid young woman with sickle cell disease who was admitted to a local hospital in Cameroon where the first author performed his internship gynecology and obstetrics. She presented at 28 weeks of gestation with severe pain in her left leg caused by a vaso-occlusive crisis. As recommended, high doses of intravenous morphine were administered, but without significant pain relief. She received a single bolus injection of 5 mg morphine, followed by a continuous infusion of 0.05 mg/kg/h during 48 h. Lumbar epidural blockade with bupivacaine combined with sufentanil successfully alleviated her severe peripheral ischemic pain induced by a vaso-occlusive crisis caused by sickle cell disease. Until now, only one case report and no clinical trials have been published concerning the use of epidural analgesia for treatment of a vaso-occlusive crisis of sickle cell anemia in a pregnant woman who is not in labor.
authors.affiliation: Catholic University Leuven, Nieuwe Wandeling 9, 8670, Koksijde, Belgium. sorenverstraete11@hotmail.com
authors.forename: Sören
authors.initials: S
authors.lastname: Verstraete
authors.forename: Rik
authors.initials: R
authors.lastname: Verstraete
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000379:methods*; D000755:Anemia, Sickle Cell / Q000150:complications*; D005260:Female; D006801:Humans; D009020:Morphine / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D014652:Vascular Diseases / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D009020:Morphine