{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T13:14:53Z","timestamp":1775135693973,"version":"3.50.1"},"reference-count":12,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Sickle cell vaso-occlusive crisis (VOC) may present with severe refractory pain that is difficult to control despite guideline-directed multimodal therapy and high-dose opioids. Case Presentation: We report an adult with VOC and severe, opioid-refractory anterior thigh and leg pain who was treated with bilateral, ultrasound-guided continuous femoral nerve catheters (0.5% bupivacaine bolus per side followed by infusion of 0.2% ropivacaine at 5 mL\/h each). Twenty-four-hour opioid use decreased by 76% from 44 mg intravenous hydromorphone (880 MME) before block placement to 10.4 mg (208 MME) after catheter initiation. Pain scores declined significantly from 10\/10 to 3\/10, facilitating mobilization and expediting discharge of the patient. No local anesthetic systemic toxicity occurred, and transient quadriceps weakness was managed with fall-risk precautions. IRB approval for this case report was waived per our institution policy. Conclusions: In select adults with VOC and predominant anterior thigh\/leg pain, bilateral continuous femoral nerve catheters may provide rapid analgesia and substantial opioid-sparing benefits as part of multidisciplinary care. These findings are hypothesis-generating and support prospective evaluation of continuous peripheral nerve block strategies in VOC.<\/jats:p>","DOI":"10.3390\/reports9020110","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:51:03Z","timestamp":1775130663000},"page":"110","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral Continuous Femoral Nerve Blocks as an Opioid-Sparing Strategy for Refractory Lower Extremity Pain in Adult Sickle Cell Crisis: A Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3186-9474","authenticated-orcid":false,"given":"Thomas","family":"Renfrew","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care, SSM Health Saint Louis University Hospital, Saint Louis, MO 63104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, SSM Health Saint Louis University Hospital, Saint Louis, MO 63104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, SSM Health Saint Louis University Hospital, Saint Louis, MO 63104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4220-4979","authenticated-orcid":false,"given":"Yuri C.","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, SSM Health Saint Louis University Hospital, Saint Louis, MO 63104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5137-1994","authenticated-orcid":false,"given":"Hamed","family":"Sadeghipour","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, SSM Health Saint Louis University Hospital, Saint Louis, MO 63104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1100\/tsw.2008.157","article-title":"Sickle Cell Anemia, the First Molecular Disease: Overview of Molecular Etiology, Pathophysiology, and Therapeutic Approaches","volume":"8","author":"Steinberg","year":"2008","journal-title":"Sci. World J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Dotsu, Y., Yamaguchi, H., Fukuda, M., Suyama, T., Honda, N., Umeyama, Y., Taniguchi, H., Gyotoku, H., Takemoto, S., and Tagawa, R. (2021). Real-World Incidence of Febrile Neutropenia among Patients Treated with Single-Agent Amrubicin: Necessity of the Primary Prophylactic Administration of Granulocyte Colony-Stimulating Factor. J. Clin. Med., 10.","DOI":"10.3390\/jcm10184221"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1182\/bloodadvances.2020001848","article-title":"Chemical inhibition of PAPD5\/7 rescues telomerase function and hematopoiesis in dyskeratosis congenita","volume":"4","author":"Shukla","year":"2020","journal-title":"Blood Adv."},{"key":"ref_4","unstructured":"Fingar, K.R., Owens, P.L., Reid, L.D., Mistry, K.B., and Barrett, M.L. (2019). Characteristics of Inpatient Hospital Stays Involving Sickle Cell Disease, 2000\u20132016, Agency for Healthcare Research and Quality. 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Pain Res."},{"key":"ref_12","first-page":"e70040","article-title":"Continuous Catheter Techniques Versus Single-Injection Nerve Blocks: A Comprehensive Review of Postoperative Pain Management Strategies","volume":"16","author":"Singhal","year":"2024","journal-title":"Cureus"}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/2\/110\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T12:20:49Z","timestamp":1775132449000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/2\/110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["reports9020110"],"URL":"https:\/\/doi.org\/10.3390\/reports9020110","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]}}}