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Volume 28, Issue 145, March 2024

Opioids used to manage acute pain crisis in adults with sickle cell disease in emergency department: Systematic review

Ahmed Saad Aleid¹, Haitham Mohammed Alhussain², Sultan Suwailem Alghannami³, Yazeed Ibrahim Altheiban³

¹Emergency Medicine Consultant, Emergency Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
²Consultant of Epidemiology and Public Health, King Fahad Hospital, Alhasa, Alhofuf, Saudi Arabia
³Saudi Board Emergency Medicine Resident, Emergency Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia

ABSTRACT

Background: In Saudi Arabia, sickle-cell disease is among the most prevalent hematologic hereditary illnesses. In SCD patients, vascular-occlusive pain crises are a common reason for emergency room visits, and patients' suffering may go untreated. This research offers a systematic literature review of the current treatments for acute pain crises in SCD patients. Method: The authors examined five scientific databases—MEDLINE, PubMed, CENTRAL, CINAHL, and Web of Science—to locate published works through 2023. For every database, a comprehensive search strategy was developed using MeSH keywords. The phrases opioids, anemia, sickle cell, double-blinded, randomized controlled study, acute pain, and clinical trial are used. Results: Six full-text articles with 424 patients were included for our review out of the 201 articles initially gathered from databases. Duplication was removed, and the articles were assessed against inclusion criteria. Of the included studies, three were conducted in the United States, one in Connecticut, one in Maryland, and one in Canada. Using guidelines for higher opioid doses for acute painful episodes in SCD patients was related to better pain outcomes and fewer hospitalizations. According to current standards, patients with SCD should get opioid analgesia within 30 minutes of being triaged. Conclusion: Almost all SCD patients who were hospitalized as a result of acute pain were provided opioids; there's no set method in strict accordance with guidelines from the Centers for Disease Control and Prevention.

Keywords: Sickle cell disease, acute pain, emergency department, opioid