Treating sickle cell pain like cancer pain

Ann Intern Med. 1992 Mar 1;116(5):364-8. doi: 10.7326/0003-4819-116-5-364.


Objective: To assess the effect of a structured analgesic regimen on hospital use by patients with sickle cell disease.

Intervention: Intravenous and oral controlled-release morphine was used instead of intramuscular meperidine and short-acting oral opioids for the treatment of sickle cell pain.

Design: Time series in which emergency and admission records for four 6-month periods before and two 6-month periods after the institution of the new analgesic protocol were reviewed.

Setting: Inner-city university hospital providing care for adults with sickle cell disease.

Patients: All patients (an average of 50) who used the emergency department of the inpatient medical service for treatment of sickle cell crisis during the study periods.

Measurements and main results: The number of admissions for sickle cell pain decreased by 44%, total inpatient days by 57%, length of hospital stay by 23%, and the number of emergency department visits by 67% after initiation of the morphine protocol. Hospital use remained at these lower levels one year later. Similar declines were seen for a subset of 15 patients who had a history of frequent admissions for sickle cell pain and who used this hospital exclusively and accounted for more than half of the admissions for sickle cell disease.

Conclusions: A pain-control program modeled on regimens used to treat chronic cancer pain reduced hospital use by adult patients with sickle cell pain.

MeSH terms

  • Acute Disease
  • Administration, Oral
  • Adult
  • Anemia, Sickle Cell / complications*
  • Clinical Protocols
  • Cohort Studies
  • Delayed-Action Preparations
  • Drug Administration Schedule
  • Emergency Service, Hospital / statistics & numerical data
  • Evaluation Studies as Topic
  • Female
  • Hospitalization
  • Humans
  • Infusions, Intravenous
  • Injections, Intravenous
  • Length of Stay
  • Male
  • Morphine / administration & dosage*
  • Pain / drug therapy*
  • Pain / etiology


  • Delayed-Action Preparations
  • Morphine