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- Title
A multimodal pain protocol for treatment of vaso‐occlusive crisis in patients with sickle cell disease: Implementation and evaluation.
- Authors
Admiraal, 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.
- 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.
- Subjects
SICKLE cell anemia; PAIN management; PATIENT reported outcome measures; MEDICAL protocols; COMBINED modality therapy; CANCER pain
- Publication
European Journal of Haematology, 2023, Vol 111, Issue 3, p382
- ISSN
0902-4441
- Publication type
Article
- DOI
10.1111/ejh.14017