Commonly used agent for acute pain management of sickle cell anemia in Saudi Emergency Department: A narrative review

Abstract

Introduction Sickle-cell disease (SCD) is one of the most common hematologic inherited disorders in Saudi Arabia. Vaso-occlusive pain crisis in SCD is a major cause for emergency visits and patients’ pain may be undertreated. This study presents a narrative literature review of current agents used to manage acute pain crisis in SCD patients presenting to the emergency department in hospitals of Saudi Arabia. Method We conducted a narrative review on relevant published articles about sickle cell disease pain crisis management in Saudi Arabia and included seven relevant studies based on our inclusion criteria. Results Using our search strategy, we included 7 studies Out of 4052. Studies included were conducted in different locations in the country. Four studies were in the Eastern region while only one in Western and One in Central regions. Those studies included around 2441 patients, in total. Morphine was used in 5 studies out of the 7 included. Pethidine was used in 4. One study used Isoxsuprine and another study used tinzaparin. Conclusion We found that continuous administration of IV morphine accompanied by oral analgesics including NSAIDs and acetaminophen is the most commonly used practice for treating SCD patients presenting with a vaso-occlusive pain crisis. Possible effectiveness of tinzaparin, isoxsuprine, and pethidine as therapeutic options may be considered. However, there was no recommendation for a certain agent to be prescribed. We recommend conducting further clinical randomized-controlled trials.

Patterns and Presentation of Sickle Cell Disease in Children Attended Pediatrics Emergency Department-Security Forces Hospital-RiyadhSaudi Arabia

“…Also, in Reem A. Hejazi, et al study males patients who attended the emergency department are more than females [16].…”

An Artificial Intelligence Approach for Data Modelling Patients Inheritance of Sickle Cell Disease (SCD) in the Eastern Regions of Saudi Arabia

“…While SCD is a rare blood disorder worldwide, incidence of this disease in Saudi Arabia continues to increase mainly because consanguineous marriages are still practiced, resulting in children inheriting the disease and ultimately suffering [7]. In the eastern region of the country, disease statistics are particularly high despite government efforts to reduce disease prevalence over the past decade [8]. Children could inherent SCD from their mother or father and have a 50% risk of inheriting the disorder if one of their parents has a sickle cell gene.…”

The impact of Hydroxyurea on the rates of Vaso–occlusive crises in patients with sickle cell disease in Saudi Arabia: a single–center study

“…In Saudi Arabia, the painful VOCs episodes among SCD patients are mostly managed by HU besides opioid (e.g., codeine, hydrocodone/paracetamol, hydrocodone/ibuprofen, oxycodone, morphine, hydromorphone, oxymorphone, methadone, diamorphine and fentanyl) and non-opioid analgesics (e.g., paracetamol, celecoxib, naproxen, ibuprofen, and ketorolac) [16]. However, the impact of HU on the rates of VOCs among SCD patients has only been examined in few studies and mostly among pediatric SCD patients despite the relatively high prevalence of SCD among certain communities in Saudi Arabia [17,18].…”