Treatment of Acute Pain Crisis in a Patient with Sickle Cell Disease Using Continuous Regional Anesthesia: A Case Report.

BACKGROUND

Sickle cell disease (SCD) is a predictor of both chronic pain and acute pain crises (APC). Vaso-occlusive APC typically require an escalation of home analgesic therapy, often requiring inpatient large doses of opioid pain medications. The analgesia and distal vasodilation provided by regional anesthesia could be of theoretical benefit when treating patients with SCD who present with vaso-occlusive APC.

CASE REPORT: This case describes the treatment of a patient with SCD who presents with upper extremity APC. Her pain crisis was otherwise refractory to medical analgesic therapy and was successfully treated using continuous supraclavicular regional anesthesia. The patient remained pain-free even after discontinuation of the supraclavicular catheter 72 hours after placement.

CONCLUSION

Regional anesthesia could be considered as a reasonable non-opioid treatment modality for refractory APC in patients with SCD.