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.