Acute and Chronic Pain Management in Sickle Cell Disease

Abstract

Sickle cell disease is a genetic haemoglobin disorder affecting millions of people worldwide. Pain is one of the most commonly reported complication of sickle cell disease. Pain is further classified into two categories acute pain and chronic pain. Chronic pain is associated with more serious complications. Management of pain has a significant impact on quality of life of sickle cell disease patients. The purpose of this research is to review the available information about acute and chronic pain management in sickle cell disease. The best treatment for both acute and chronic pain requires a customized, varied approach. This approach combines therapeutic, non-pharmacological therapies, as well as integrated therapies as per the specific needs of each patient. Opioids are effectively used in management of the pain of sickle cell disease and their use is supported by literature especially in chronic pain. Methadone, ketamine, and nitrous oxide are also used to manage pain. For the treatment of acute pain, nonsteroidal anti-inflammatory medications, short-acting opioids, and adjuvants are used effectively in clinical practice. Opioids have become the recommended treatment for pain in sickle cell disease, and many chronic pain patients are sustained on opioid therapy for the rest of their lives. However, the distinction between acute and chronic opioid therapy modalities is blurred in sickle cell disease due to the association between recurring acute pain and chronic pain. Limited literature is available regarding management guidelines and therapeutic strategies so more clinical research and trials are needed in future to design and study effective management strategies for both acute and chronic pain.