Sickle cell disease: NSAIDs and education were helpful for painful crises.

Clinical bottom line (level 2a)

  1. In patients with sickle cell disease, NSAIDs and antisickling agents may reduce opiate requirements.
  2. Increased education and information may reduce emergency department visits and in-patient days.
Elander and Midence: Clinical Journal of Pain 1996; 12 (3): 180-913
Expires February 2003

The study

Systematic review of ? of
  • Patients: sickle cell disease
  • Intervention: evidence for pharmacological compared with behavioural or interpersonal
  • Outcome: pain management


    • Articles found in English using MEDLINE, PSYCHlit, BIDS, up to 1995 (search terms: )

    Selection criteria: not detailed
    Appraisal criteria: not detailed
    Articles excluded if: not detailed

    24 papers were identified involving about 715 patients (some studying children, some adults and some mixed populations).

    The evidence

    • NSAIDs and antisickling agents can reduce opiate requirements.
    • Patients found transcutaneous electrical nerve stimulation helpful, but had no reduction in recorded pain or analgesia use.
    • Increased education and information reduces emergency department visits and in-patients days.
    • There was little useful information available on the role of longer-acting opiates, patient-controlled analgesia or behavioural effects.

    Comments

    1. This was a weak systematic review.
    2. No numerical data was given.

    Citation

    1. Elander J, and Midence K: A review of evidence about factors affecting quality of pain management in sickle cell disease. Clinical Journal of Pain 1996; 12 (3): 180-913
    Contributor: Chris Ball and Clare Wotton, February 2000
    Reviewer:

    Clinical Question.
    Patient sickle cell disease
    Intervention or Exposure pharmacological, behavioural and interpersonal information
    Outcome pain management