| Title: | A multimodal pain protocol for treatment of vaso-occlusive crisis in patients with sickle cell disease: Implementation and evaluation |
| Author(s): | Admiraal M; van Daalen J; Ritt MWJ; Dekker J; van Tuijn CFJ; Nur E; Hollmann MW; Hermanns H; Hermanides J; Biemond BJ; |
| Address: | "Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Department of Haematology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands" |
| ISSN/ISBN: | 1600-0609 (Electronic) 0902-4441 (Linking) |
| Abstract: | "OBJECTIVES: Pain management during a vaso-occlusive crisis (VOC) for patients with sickle cell disease (SCD) remains a major challenge and strongly depends on opioids. We developed a multimodality pain protocol for rapid, opioid-sparing pain treatment of VOC and evaluated its feasibility. METHODS: Patients were included for evaluation if they were >/=18 years, diagnosed with SCD and visited the emergency department (ED) because of VOC between July 2018 and December 2020. Primary evaluation outcome was the feasibility of multimodal pain analgesia (i.e., the use of at least two analgesics with different underlying mechanisms of action). RESULTS: A total of 131 SCD patients visited the ED because of VOC with a total of 550 ED presentations, of which 377 were eventually hospitalised. A total of 508 (92.4%) ED presentations and 374 (99.2%) hospital admissions received multimodal pain treatment. Time to first administration of an opioid was median [IQR] 34.0 [21.0-62.0] minutes. CONCLUSION: The implementation of a pain protocol using multimodal analgesia for VOC in patients with SCD appeared to be feasible and facilitated rapid administration of opioids. Controlled trials are needed to investigate the effectiveness of multimodal analgesia on pain and should focus on patient reported outcome measures" |
| Keywords: | "Humans Analgesics, Opioid/therapeutic use *Volatile Organic Compounds Pain/diagnosis/drug therapy/etiology Pain Management/adverse effects/methods *Anemia, Sickle Cell/complications/diagnosis opioids pain sickle cell disease;" |
| Notes: | "MedlineAdmiraal, Manouk van Daalen, Jonathan Ritt, Michael W J Dekker, Joost van Tuijn, Charlotte F J Nur, Erfan Hollmann, Markus W Hermanns, Henning Hermanides, Jeroen Biemond, Bart J eng England 2023/06/06 Eur J Haematol. 2023 Sep; 111(3):382-390. doi: 10.1111/ejh.14017. Epub 2023 Jun 5" |
