{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T01:20:48Z","timestamp":1775179248056,"version":"3.50.1"},"reference-count":51,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T00:00:00Z","timestamp":1702857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University Hospital of La Guadeloupe","award":["APL 2020"],"award-info":[{"award-number":["APL 2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Pain management poses a significant challenge for patients experiencing vaso-occlusive crisis (VOC) in sickle cell disease (SCD). While opioid therapy is highly effective, its efficacy can be impeded by undesirable side effects. Local regional anesthesia (LRA), involving the deposition of a perineural anesthetic, provides a nociceptive blockade, local vasodilation and reduces the inflammatory response. However, the effectiveness of this therapeutic approach for VOC in SCD patients has been rarely reported up to now. The objective of this study was to assess the effectiveness of a single-shot local regional anesthesia (LRA) in reducing pain and consequently enhancing the management of severe vaso-occlusive crisis (VOC) in adults with sickle cell disease (SCD) unresponsive to conventional analgesic therapy. Materials and Methods: We first collected consecutive episodes of VOC in critical care (ICU and emergency room) for six months in 2022 in a French University hospital with a large population of sickle cell patients in the West Indies population. We also performed a systematic review of the use of LRA in SCD. The primary outcome was defined using a numeric pain score (NPS) and\/or percentage of change in opioid use. Results: We enrolled nine SCD adults (28 years old, 4 females) for ten episodes of VOC in whom LRA was used for pain management. Opioid reduction within the first 24 h post block was \u221275% (50 to 96%). Similarly, the NPS decreased from 9\/10 pre-block to 0\u20131\/10 post-block. Five studies, including one case series with three patients and four case reports, employed peripheral nerve blocks for regional anesthesia. In general, local regional anesthesia (LRA) exhibited a reduction in pain and symptoms, along with a decrease in opioid consumption post-procedure. Conclusions: LRA improves pain scores, reduces opioid consumption in SCD patients with refractory pain, and may mitigate opioid-related side effects while facilitating the transition to oral analgesics. Furthermore, LRA is a safe and effective procedure.<\/jats:p>","DOI":"10.3390\/medicina59122196","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T08:55:29Z","timestamp":1702889729000},"page":"2196","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pain Control for Sickle Cell Crisis, a Novel Approach? A Retrospective Study"],"prefix":"10.3390","volume":"59","author":[{"given":"Am\u00e9lie","family":"Roll\u00e9","sequence":"first","affiliation":[{"name":"Anesthesiology and Intensive Care Department, University Hospital of La Guadeloupe, F-97139 Les Abymes, France"},{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 des Antilles, INSERM, BIGR, F-75015 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsa","family":"Vidal","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care Department, University Hospital of La Guadeloupe, F-97139 Les Abymes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Laguette","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care Department, University Hospital of La Guadeloupe, F-97139 Les Abymes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2720-5829","authenticated-orcid":false,"given":"Yohann","family":"Garnier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 des Antilles, INSERM, BIGR, F-75015 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6840-6360","authenticated-orcid":false,"given":"Delphine","family":"Delta","sequence":"additional","affiliation":[{"name":"West-Indies Faculty of Medicine, University of The French West-Indies, F-97157 Pointe \u00e0 Pitre, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1389-2306","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Martino","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care Department, University Hospital of La Guadeloupe, F-97139 Les Abymes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Portecop","sequence":"additional","affiliation":[{"name":"Emergency Department, University Hospital of Guadeloupe, F-97100 Pointe \u00e0 Pitre, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryse","family":"Etienne-Julan","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 des Antilles, INSERM, BIGR, F-75015 Paris, France"},{"name":"Sickle Cell Disease Unit, Reference Centre for Sickle Cell Disease, Thalassemia and Other Red Cell Rare Diseases, CHU de la Guadeloupe, CEDEX, F-97159 Pointe \u00e0 Pitre, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4809-2912","authenticated-orcid":false,"given":"Pascale","family":"Piednoir","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care Department, University Hospital of La Guadeloupe, F-97139 Les Abymes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey","family":"De Jong","sequence":"additional","affiliation":[{"name":"Anesthesia and Critical Care Department, Saint Eloi Teaching Hospital, University Montpellier 1, 80 Avenue Augustin Fliche, CEDEX 5, F-34295 Montpellier, France"},{"name":"Phymed Exp INSERM U1046, CNRS UMR 9214, F-34295 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8715-9836","authenticated-orcid":false,"given":"Marc","family":"Romana","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 des Antilles, INSERM, BIGR, F-75015 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Bernit","sequence":"additional","affiliation":[{"name":"Sickle Cell Disease Unit, Reference Centre for Sickle Cell Disease, Thalassemia and Other Red Cell Rare Diseases, CHU de la Guadeloupe, CEDEX, F-97159 Pointe \u00e0 Pitre, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1016\/S0140-6736(10)61029-X","article-title":"Sickle-cell disease","volume":"376","author":"Rees","year":"2010","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1056\/NEJMra1510865","article-title":"Sickle Cell Disease","volume":"376","author":"Piel","year":"2017","journal-title":"N. 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