Abstract

BACKGROUND

While pain is the hallmark of sickle cell disease (SCD), healthcare personnel are often ill-equipped to adequately treat patients who present in vaso-occlusive crisis (VOC). Although symptom severity varies from individual to individual, SCD is characterized by intervallic pain as a result of oxygen deprivation in tissues and organs. Regardless of pain severity, SCD patients are often viewed as drug seekers by healthcare personnel who have concerns regarding patients' dependence on opioids which may lead to addiction. The objective was to assess the types and amount of opioids used to treat VOC in comparison to Centers for Disease Control opioid prescription guidelines.

METHODS

Literature search was conducted using CINAHL, PubMed, the Cochrane Library, Web of Science and hand search. Data were analyzed from 1999 to 2018. Randomized trials, observational, and case studies involved hospitalized adults with SCD who were prescribed opioids to treat VOC. Quality assessment was conducted using Downs and Black checklist. Meta-analysis was not conducted.

RESULTS

Five studies were conducted in the USA, Arabia and the Netherlands, and the USA and Canada were included. Participants were treated with either morphine or morphine milligram equivalent (MME). No study used the same method of opioid administration.

CONCLUSIONS

Patients with SCD who are hospitalized secondary to VOC mostly received opioids for pain well within the Centers for Disease Control and Prevention prescription guidelines. No uniform method exists. Additional research is warranted.

MeSH

Cells, Morphine, Anemia, Sickle Cell, Pain, Prescriptions, Centers For Disease Control And Prevention, U.S., Vaso-Occlusive Crises

Cited by

• The Associations Between Opioid Use Disorder and Healthcare-Related Outcomes in Vaso-occlusive Crisis. J Gen Intern Med, 2024
• Opioid Use in Patients With Sickle Cell Disease During a Vaso-Occlusive Crisis: A Systematic Review. Cureus, 2022
• Association between trauma triage and time-to-vaso-occlusive events in patients with sickle cell disease after traumatic injury: a retrospective study. Trauma Surg Acute Care Open, 2023
• Quality of Life and Out-of-Pocket Expenditures for Sickle Cell Disease Patients in Saudi Arabia: A Single-Center Study. Healthcare (Basel), 2024
• Guidelines for the management of emergencies and critical illness in pediatric and adult patients with sickle cell disease. Ann Intensive Care, 2025
• The Evaluation of Patient-Controlled Analgesia Compared to Standard Opioid Analgesic Therapy in Pain Management Among Patients With Sickle Cell Disease: A Systematic Review and Meta-Analysis Protocol. Health Sci Rep, 2025