Pain Syndromes in Sickle Cell Disease: An Update

Niscola, Pasquale; Sorrentino, Francesco; Scaramucci, Laura; Fabritiis, Paolo de; Cianciulli, Paolo

doi:10.1111/j.1526-4637.2009.00601.x

Cited by 56 publications

(64 citation statements)

References 87 publications

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“…Sickle cell crises involving abdominal organs can mimic an acute surgical abdomen. Acute chest syndrome secondary to sickle cell disease may present with chest pain, cough, dyspnoea and fever (Niscola et al, 2009). …”

Section: Sickle Cell Diseasementioning

confidence: 99%

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Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Sickle Cell Diseasementioning

confidence: 99%

“…Haemoglobin S polymerises when deoxygenated, causing rigidity of the erythrocytes, blood hyperviscosity and occlusion of the microcirculation with resultant tissue ischaemia and infarction (Niscola et al, 2009). …”

Section: Sickle Cell Diseasementioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…Classic clinical examples include sickle cell disease (SCD) (Niscola et al, 2009) and episodic migraine , where repeated episodic crises in SCD may emerge into a chronic pain state (Hollins et al, 2012) and the progression of migraine frequency, from episodic migraine into chronic migraine (Bigal and Lipton, 2008a; May and Schulte, 2016). In both cases, summation of repeated attacks affecting or involving afferent sensory systems may induce brain changes leading to a cascade that presents with a chronic pain condition.…”

Section: When Pain Pops Out To Conscious Awareness – Insights Frommentioning

confidence: 99%

Subliminal (latent) processing of pain and its evolution to conscious awareness

Borsook

Youssef

Barakat

et al. 2018

Neuroscience & Biobehavioral Reviews

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By unconscious or covert processing of pain we refer to nascent interactions that affect the eventual deliverance of pain awareness. Thus, internal processes (viz., repeated nociceptive events, inflammatory kindling, re-organization of brain networks, genetic) or external processes (viz., environment, socioeconomic levels, modulation of epigenetic status) contribute to enhancing or inhibiting the presentation of pain awareness. Here we put forward the notion that for many patients, ongoing sub-conscious changes in brain function are significant players in the eventual manifestation of chronic pain. In this review, we provide clinical examples of nascent or what we term pre-pain processes and the neurobiological mechanisms of how these changes may contribute to pain, but also potential opportunities to define the process for early therapeutic interventions.

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“…Painful episodes, defined as body pain complaints (excluding head pain) which require administration of opioids, are the most common cause of morbidity in sickle cell disease and are associated with an increased risk of early death [37]. Children with >3 episodes of pain per year have higher reports of breathing difficulty and chest pain [38].…”

Section: Painful Episodes and Respiratory Symptomsmentioning

confidence: 99%

Asthma in Sickle Cell Disease: Implications for Treatment

Blake

Lima

2011

Anemia

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Objective. To review issues related to asthma in sickle cell disease and management strategies. Data Source. A systematic review of pertinent original research publications, reviews, and editorials was undertaken using MEDLlNE, the Cochrane Library databases, and CINAHL from 1947 to November 2010. Search terms were [asthma] and [sickle cell disease]. Additional publications considered relevant to the sickle cell disease population of patients were identified; search terms included [sickle cell disease] combined with [acetaminophen], [pain medications], [vitamin D], [beta agonists], [exhaled nitric oxide], and [corticosteroids]. Results. The reported prevalence of asthma in children with sickle cell disease varies from 2% to approximately 50%. Having asthma increases the risk for developing acute chest syndrome , death, or painful episodes compared to having sickle cell disease without asthma. Asthma and sickle cell may be linked by impaired nitric oxide regulation, excessive production of leukotrienes, insufficient levels of Vitamin D, and exposure to acetaminophen in early life. Treatment of sickle cell patients includes using commonly prescribed asthma medications; specific considerations are suggested to ensure safety in the sickle cell population. Conclusion. Prospective controlled trials of drug treatment for asthma in patients who have both sickle cell disease and asthma are urgently needed.

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Pain Syndromes in Sickle Cell Disease: An Update

Cited by 56 publications

References 87 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Subliminal (latent) processing of pain and its evolution to conscious awareness

Asthma in Sickle Cell Disease: Implications for Treatment

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