How Would You Treat This Patient With Acute and Chronic Pain From Sickle Cell Disease? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
Zahir KanjeeMaureen Okam AchebeWally R SmithRisa B BurnsPublished in: Annals of internal medicine (2022)
Sickle cell disease is prevalent in large numbers of patients in the United States and has a significant global impact. Its complications span numerous organs and lead to reduced life expectancy. Acute and chronic sickle cell pain is a common cause of patient suffering. The American Society of Hematology published updated guidelines on management of acute and chronic pain from sickle cell disease in 2019. Several of the recommendations are conditional and leave specific decisions to the treating physician. These include conditional recommendations about the use of ketamine for acute pain and the initiation and discontinuation of long-term opioid therapy for chronic pain. Here, 2 hematologists discuss these guidelines and make contrasting recommendations for the management of acute and chronic pain for a patient with sickle cell disease.
Keyphrases
- chronic pain
- sickle cell disease
- liver failure
- pain management
- respiratory failure
- drug induced
- clinical practice
- aortic dissection
- case report
- end stage renal disease
- primary care
- hepatitis b virus
- chronic kidney disease
- ejection fraction
- systematic review
- risk factors
- spinal cord
- intensive care unit
- prognostic factors