Emergency Department Oligoanalgesia for Sickle Cell Vaso-Occlusive Crisis

Patients with sickle cell anemia often have very high opioid tolerances, and when they present with the pain of vaso-occlusive crisis, their opioid requirements can be intimidating. Investigators retrospectively compared pain severity and opioid administration among adults receiving care in a single center's emergency department (ED) versus an affiliated specialized sickle cell anemia clinic.

The study included a total of 217 visits to the ED, clinic, or both by 148 adult patients over 2 years. Pain was significantly worse at visits to the ED, both on arrival (mean scores of 8.7 vs. 8.0 on a 10-point verbal scale) and at discharge (6.4 vs. 4.5). However, opioid doses were significantly lower in the ED, whether measured as intravenous morphin…