Management of vasoocclusive pain events in sickle cell disease

Pain is the clinical hallmark of sickle cell disease (SCD). Vasoocclusive pain events (VOEs) are the primary cause of morbidity and account for most emergency department visits and hospitalizations for patients with SCD in the United States and Europe. The nature of VOE makes its management extremely challenging. There are no large controlled trials of analgesic regimens for VOE, and smaller trials have generally failed to produce an optimal course of therapy. Therefore, treatment recommendations are largely based on expert opinion and anecdotal experience. Although VOEs are not life-threatening, inadequate treatment may result in unnecessary morbidity and life-threatening complications. Health care providers caring for patients with SCD must be well informed about the management of VOE. This continuing medical education article will provide a summary of the management of acute pain events in SCD with particular emphasis on adequate analgesia.