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Vaso-occlusive pain management in sickle cell disease

Michael R DeBaun, MD, MPH
Elliott P Vichinsky, MD
Section Editors
Donald H Mahoney, Jr, MD
Stanley L Schrier, MD
Deputy Editor
Jennifer S Tirnauer, MD


Acute, painful episodes are the most common reason for individuals with sickle cell disease (SCD) to seek medical attention. The frequency of pain episodes is likely to be underestimated because these episodes are managed at home, especially as individuals with SCD grow older and learn how to manage pain on their own.

No evidence-based guidelines exist for the treatment of SCD-associated acute pain episodes, either in the hospital or at home. However, reasonable strategies can be employed that are based on established principles of pain management and pharmacokinetics of opioids. Our approach to the management of painful episodes in children and adults with SCD is discussed here.

Separate topic reviews discuss the evaluation for other SCD complications that present with pain, the mechanisms of vaso-occlusive pain, and other aspects of the management of sickle cell disease:

Acute evaluation for SCD complications that present with pain – (see "Evaluation of acute pain in sickle cell disease")

Pain mechanisms – (see "Mechanisms of vaso-occlusion in sickle cell disease")

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Literature review current through: Sep 2017. | This topic last updated: Oct 11, 2017.
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