Management of pain in sickle cell disease
| Acute pain Parenteral opioids Nonsteroidal anti-inflammatory drugs (NSAIDs) Frequent reevaluation for pain relief |
| Chronic pain NSAIDs, gabapentin, antidepressants (tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors) Opioids: for pain not relieved by nonopioids and nonpharmacologic interventions Refer to mental health professional as needed for depression, anxiety, dependence on pain medication Nonpharmacologic: cognitive behavioral therapy, massage, meditation, relaxation techniques, transcutaneous electrical nerve stimulation Collaborate with patient to develop a written individualized treatment plan Educate patient to increase oral hydration and use stool softeners as needed |
From National Heart, Lung, and Blood Institute. Evidence-based management of sickle cell disease: Expert panel report, 2014. www.nhlbi.nih.gov/guidelines.