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Turkish Journal of Medical Sciences

Author ORCID Identifier

ALİOUNE DIALLO: 0000-0002-0620-873X

MOUSSA SECK: 0000-0002-0561-6707

MOHAMED KEITA: 0000-0003-4100-4684

SOKHNA', 'SOKHNA AİSSATOU TOURÉ: 0000-0003-0251-1368

ELIMANE', 'ELİMANE SEYDİ BOUSSO: 0009-0007-3148-4289

BARON NGASIA: 0009-0007-0292-7562

BLAISE', 'BLAİSE FÉLİX FAYE: 0000-0001-7066-7984

FATMA DIENG: 0009-0007-7717-2299

SALİOU DIOP: 0000-0002-2354-3839

DOI

10.55730/1300-0144.5897

Abstract

Background/aim: The evolution of sickle cell disease (SCD) is marked by the occurrence of painful episodes linked to the obstruction of micro-vessels by sickle cells, known as vaso-occlusive crises (VOC). The aim of our work was to report the practical aspects of the management of acute pain in adults with SCD. Recommendations based on these practices are also provided.Materials and methods: We conducted a prospective, cross-sectional, descriptive and analytical study over a 4-month period of all sickle cell patients admitted to emergency departments for VOC. The parameters studied were sociodemographic, clinico-biological, therapeutic and evolutionary.Results: 118 cases of VOC were identified, representing a prevalence of 78.14% of sickle cell emergencies. The mean age of the patients was 28.41 years. The SS sickle cell phenotype accounted for 86.61% of cases. Osteoarticular pain was the reason for admission in 88.39% of cases; it was located in the lower limbs in 39.08% of cases and in the spine in 27.1% of cases. Pain intensity was moderate in 6.25% of cases, intense in 31.25% and unbearable in 55.55%. Multimodal analgesia was the most commonly used treatment method, combining levels 1 and 2 (74.31%) and levels 1 and 3 (8.25%). The mean dose of morphine administered was 17.14 mg when morphine alone was prescribed for titration, 13.57 mg when paracetamol and morphine were combined, and 15.83 mg when nefopam and morphine were combined. Clinical outcome was favourable in 68.87% of cases.Conclusion: We noticed a wide variability in the modalities of analgesic treatment of sickle cell VOC. These variations reflect different views on the appropriateness of opioids. This study highlights the efficacy of multimodal analgesia in the management of acute pain in patients with SCD, particularly with regard to morphine sparing. Context-specific recommendations will be needed to harmonize practices.

Keywords

Senegal, Sickle cell disease, vaso-occlusive crisis

First Page

1185

Last Page

1189

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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